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GUIDE TO THERAPEUTICS 



MATERIA MEDICA. 



v 



BY 



ROBERT FARQUHARSON, M.P., M.D., Edin., 
V *F.R.C.P. Lond., LL.D. Aber., 

LATE LECTURER ON MATERIA. MEDICA AT ST. MARY'S HOSPITAL 
MEDICAL SCHOOL, ETC. 

FOURTH AMERICAN, FROM THE FOURTH ENGLISH, EDITION. 

ENLARGED SO AS TO INCLUDE ALL PREPARATIONS OFFICINAL 
IN THE U. S. PHARMACOPOEIA, 



BY 

FRANK WOODBURY, A.M., M.D., 

FELLOW OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA, PROFESSOR OF 

MATERIA MEDICA, THERAPBUTICS AND OF CLINICAL MEDICINE IN 

THE MEDICO-CHIRURGICAL COLLEGE OF PHILA." ETC. 








PHILADELPHIA : 

LEA BROTHERS & CO. 

1889. 



4> 



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Entered according to the Act of Congress, in the year 1889, by 

LEA BROTHERS & CO., 
in the Office of the Librarian of Congress. All rights reserved. 



COLLINS PRINTING HOUSE, 

705 Jayne Street. 



X- 



AMERICAN EDITOR'S PREFACE 



TO 



THE FOURTH EDITION. 



Although the fourth English edition of this work 
was practically rewritten and very considerably en- 
larged, so rapid has been the advance in therapeutics 
and so great the additions to our materia medica that 
the American editor has found it necessary to make very 
many additions so as to make the body of the work 
include all the remedies and preparations of the last 
revision of the United States Pharmacopoeia; a number 
of non-officinal but important new drugs are considered, 
thus making the work as complete in the department 
of materia medica as it is in therapeutics — a miniature 
dispensatory in fact. In view of the recent publication 
of the Formulary of the American Pharmaceutical 
Association, containing many valuable formula? that 
physicians should be familiar with, it has been, deemed 
advisable also to add this, although it has increased the 
size of the book by nearly sixty pages. The appropriate 
pharmacopoeial definitions have been systematically intro- 
duced throughout, giving under each remedy the descrip- 
tion and botanical natural order in the case of plants, and 



iv AMERICAN EDITOR'S PREFACE. 

the chemical formulae in all other drugs ; and new pre- 
scriptions have been added to bring the book up to date. 

In its present form, which retains all the special 
features which characterized the work in its former 
editions, it is believed that it will prove to be even more 
acceptable than it has been heretofore, and that it will 
continue to serve a useful purpose as a handy reference 
book on therapeutics and materia medica to the busy 
practitioner as well as to the medical student. 



F. W. 



Philadelphia, May 1, 1889. 

No. 218 South Sixteenth Street. 



PREFACE 



TO 



THE FOURTH EDITION. 



The preparation of this edition has been made more 
laborious than usual by the recent appearance of the 
British Pharmacopoeia of 1885, and the very extensive 
alterations and additions which it contains. It would 
have been impossible for me to have made adequate 
reference to these had it not been for the kindness of 
Dr. Quain, who gave me the opportunity, of which I 
have freely availed myself, of working through an early 
copy of the new edition. The principal changes made 
have been in the direction of leaving out certain sub- 
stances which have become obsolete, and of adding a 
large number of others which have obtained a firm hold 
on professional confidence. 

The omissions are seventeen in number, and consist of 
areca nut, iodide of cadmium and its ointment, castor 
and its tincture, elm bark and its decoction, digitalin, 
dulcamara and its infusion, iodide of iron (solid), mag- 
netic oxide and moist peroxide of iron, green iodide of 
mercury, tobacco enema, solution of atropia, gentian 
mixture, quinine pill, buckthorn juice and its syrup, 
acetate of soda and stramonium leaves. I would gladly 
have seen this list much extended, and made to include 
a large number of utterly useless articles which still 



VI PREFACE TO THE FOURTH EDITION. 

linger on in our text-books, and whose reputation de- 
pends on a mysterious and unscientific catalogue of sup- 
posed virtues handed down from one generation of au- 
thorities to another. I should like to have seen a clean 
sweep made of these, and must express some disappoint- 
ment that official sanction has not been given to lighten- 
ing the pages of our manuals of materia medica and the 
memory of the overtaxed student of many drugs which 
no one ever dreams of prescribing; and which, in some 
instances, probably could not be found if they were 
wanted. But if the pruning-knife has been used with 
unnecessary caution, the list of additions is an admirable 
one, and, containing, as it does, 113 primary articles and 
their preparations, it includes all the recently introduced 
drugs which seem to stand on a firm basis and which 
have already proved useful in practice. Some other alter- 
ations have been made, one of which is an attempt to 
standardize the strength of the preparations of certain 
active drugs, and another to make the names of the alka- 
loids terminate in -ine. 

In conclusion, I have to thank my friend, Mr. Car- 
tetghe, President of the Pharmaceutical Society, for 
many valuable practical suggestions, and to acknowledge 
the great benefit I have derived from a study of the im- 
portant works recently published by Drs. Lauder Brun- 
ton (a text-book of Pharmacology, Therapeutics and 
Materia Medica) and Mitchell Bruce (Materia Medica 
and Therapeutics). 

R. F. 

London, 

23 Brook St., Grosvenor Square W. 



TABLE OF CONTENTS. 



PAGE 

Introduction 25 

The Routes by which Medicines enter the Circulation 26 
General Rules for Prescribing . . . . .31 

Prescribing for Children ...... 45 

Weights and Measures . . . ' . .49 

General Plan . . 51 

Remarks on Certain Classes of Remedte#° $Bta&w ^56 
Summary of Action of^^m&^fem&l ^^ ef/jq £1 
Chnico- Physiological ClaWj&,e.a,tioftfrr hew tobo oiiBmoKs oft& 
sail otls jI .xx-v JS-% lo zeaob ai 

Drugs and Preparations OrF^Mt 9 f^¥irV;^NW^ I/ n " d 
States Pharmacopoeia . . . . . .95 

Non-Officinal Preparations 500 

Questions ......... 508 



APPENDIX (to American Edition). 

Poisons . . 513 

Epitome of the National Formulary . . . 521 

Weights and Measures 562 

Therapeutic Suggestions; or Index of Diseases 56 7 

General Index 589 



ERRATA. 

Page 211, line 25, for "chloride," read "sulphide." 

Page 382, after line 7, insert the following : — 

"OLEUM ERIGERONTIS— OIL OF ERIGERON. 

A volatile oil distilled from the fresh flowering herb of Erigeron 
Canadense, Linne (N. 0. Compos it oz) . 
A pale yellow liquid with slightly pungent taste and character- 
istic aromatic odor used in hemorrhage, especially from the uterus, 
in doses of gtt. v-xx. It also has diuretic properties, and has 
"been used in the treatment of gonorrhoea." 



THERAPEUTICS 



MATERIA MEDICA. 



INTRODUCTION. 

Previous to the study of the individual articles com- 
prised within our national Pharmacopoeia, the temptation is 
very strong to launch forth into a disquisition upon the gen- 
eral principles of therapeutics. So many interesting physi- 
ological considerations are involved in the actions and uses 
of drugs, and so many important illustrations might readily 
be drawn from the wide field of practical medicine, that 
little apology would really be needed for consuming some 
of our space in this way. Therapeutics has lately shown a 
systematic vitality which amply redeems its credit from the 
old-fashioned accusation of want of progress, for perhaps in 
no other department of our profession have more solid and 
satisfactory advances been made. But this very condition 
of vigor renders far more laborious and responsible the task 
of attempting to reduce to anything like precision the laws 
on which we are henceforth to prescribe our drugs, or to 
draw complete generalizations from the enormous mass of 
complicated material now at our disposal. Progress occa- 
sionally causes temporary confusion, by disturbing old beliefs 
and furnishing vast legions of sometimes unconfirmed and 
possibly ill-digested facts ; and our present subject is by no 
means exempt from this almost inevitable tendency of true 
science. 

A careful study of the many exhaustive works on thera- 
peutics published within the last twenty years brings before 
us a strange medley of experimental evidence, confusing and 
contradictory it mav be at times, but giving most encour- 
3 



26 INTRODUCTION. 

aging proofs of the large amount of honest and, persevering 
work now being devoted to the elucidation of this, the most 
important department of practical medicine. In the follow- 
ing pages we must necessarily assume a dogmatic attitude, 
and if the extreme precision with which our plan compels 
us to lay down the actions of drugs offends many whose faith 
is undeveloped or wavering, we can only excuse ourselves 
by pleading a conscientious desire to contribute something 
towards a more scientific scheme of arrangement. Although 
the time has not yet fully come for a complete explanation 
of all the therapeutical effects of medicinal agents by their 
proved physiological properties, we have ventured to take a 
step in this direction, and must only Jiope that our very de- 
fects and failures may be of use in helping others to develop 
our principles with greater success. 



THE ROUTES BY WHICH MEDICINES ENTER 
THE CIRCULATION. 

1. External Method of Application. — By this 
we do not mean the merely local action of irritants, caustics, 
or sedatives, but the attempts which we make to utilize the 
absorptive function of the cutaneous surface for therapeutic 
purposes. Now, the skin would, at first sight, seem to be 
a very convenient and tempting arrangement for passing our 
medicines directly into the blood ; but, unfortunately for this 
purpose, the vascular cutis vera is protected by the horny 
epidermis, which interposes a very considerable barrier to 
absorption. Much discussion has arisen on this point, and 
it now seems pretty certain that most drugs cannot permeate 
the epidermis readily, if at all, and hence this — (a) the 
epidermic, as it has been styled, or the method by inunction 
— is not of very wide application, save in the administration 
of mercury and sometimes belladonna and digitalis. Fats 
[especially wool-fat or lanoline] and oils, and probably gly- 
cerine, increase our chances of procuring absorption in this 
way [particularly if applied with friction, or " rubbed in"] ; 
alcohol may be of service by dissolving the sebaceous secre- 
tion of the skin. 

The cuticle, then, being our chief obstacle, it would seem 
an easy matter to overcome the resistance by its removal, 
and indeed this, (b) the endermic plan, as it is called, 



METHODS OF ADMINISTERING MEDICINES. 27 

has done some good service in therapeutics. Having pro- 
cured a raw surface by blister, we may apply morphine, 
strychnine, or any drug we may wish to use, directly to the 
cutis vera, and thus obtain an undeniably active effect. But 
the process is slow and painful, it may be disfiguring, and 
cannot be very frequently repeated, and it has therefore been, 
justly, almost entirely superseded by (c) the hypodermic 
plan. This, being a rapid, economical, and most efficient 
proceeding, has come into very general use, the principal 
drawback being that the pleasant, soothing influence and re- 
lief from pain which morphine thus gives our patients have 
introduced a form of opium-habit, perhaps hardly less obsti- 
nately adhered to than the older-fashioned form. Unfortu- 
nately, however, not all drugs, nor even all alkaloids, are 
available for this method of administration, as two conditions 
are requisite for success — the fluid to be injected must be 
small in bulk, and it must be unirritating to the parts. 
Chloral has been thus used, but without much success; 
quinine, though efficient, is unhappily irritating ; l ergotine 
produces hard, discolored, and painful lumps ; mercury often 
causes abscess; and practically we are almost restricted to 
morphine, atropine, and strychnine, and of these the first 
named is by far the most available. We may refer to a de- 
scription of the way in which the little operation is performed, 
under the subject Opium, remembering always that drugs act 
three or four times more powerfully when given by hypo- 
dermic injection than by the mouth. 

Some authorities advise us to carry these injections boldly 
into the substance of the muscles, and it is said that strych- 
nine thus acts well in some forms of paralysis, (d) The 
parenchymatous method, as this is called, finds special favor 
abroad, and we are told that from five to twenty minims of 
chloroform, thus introduced, deeply into the thigh is a sure 
cure for sciatica, but the excruciating pain following the 
operation and the trifling and temporary benefit it produced, 
have convinced us that the remedy may be even worse 
than the disease. 

Then, again, injections may be made directly into the 
veins, and this would, theoretically, seem to be the best, be- 
cause the most straightforward of all methods. We must 

[* Several cases have been reported of death from tetanus follow- 
ing the hypodermic injection of quinine.] 



28 INTRODUCTION. 

not forget, however, that many drugs require to be acted 
on by some of the digestive juices before their due therapeu- 
tic powers are developed, and that the dangers of phlebitis, 
thrombosis, and of the admission of air into the veins, with all 
their perilous consequences, cannot be overlooked, (e) Intra- 
venous injection is therefore reserved for very desperate 
cases, and the most notable illustration is in the operation 
for transfusion, by which, after severe hemorrhage, lives 
have undoubtedly been saved. The intra-venous injection 
of chloral, so much praised abroad, has, so far as 1 know, 
been hardly practised at home. [It has proved suddenly 
fatal in several cases.] 

2. Internal Administration. — 1. Inhalation must 
stand first, on account of the great facility of its application, 
of its remarkable efficiency, and the great purity, so to speak, 
with which drugs thus enter the blood. Anaesthesia pro- 
duced by chloroform, ether, or laughing-gas will occur, as 
the leading example, to every mind, and we know that the 
British Pharmacopoeia has recently acknowledged the prin- 
ciple by the admission of six vapors, — creasote, iodine, hy- 
drocyanic acid, chlorine, oil of pinus sylvestris, and conium. 
But little use, however, has yet been made of this tempting 
channel for the administration of agents intended to act on 
the system generally, perhaps partly because it is a matter 
of doubt as to how far the delicate structures of the air-cells 
might be tolerant of the prolonged or repeated contact with 
possibly irritating substances. At present inhalation has 
been almost confined to the treatment of lung diseases, and 
ipecacuanha, arsenic, stramonium, tannin, and carbolic acid 
have been thus employed ; but there is no doubt that this 
plan is capable of much wider development, and that the 
Germans are far ahead of us in this respect. It is evident, 
however, that a barrier must always exist to the very ex- 
tended adoption of aerial medication, by the irritant nature 
of many medicines, and the impossibility of reducing many 
of them to that minute subdivision which is essential for 
either ordinary inhalation or the formation of a readily ab- 
sorbable spray. 

2. Medicinal agents may be injected into any of the open 
cavities of the body. The rectum is much used in this way, 
and enemata, clysters, or injections, as they are called, may 
be divided into three classes. 

a. Purgative Enemata For efficient and easy evacua- 



METHODS OF ADMINISTERING MEDICINES. 29 

tion of the large bowel, no method can compare to this, the 
principal points to remember being that the injection must 
be ample, from twelve ounces to a pint, must be passed up as 
far as possible, and must be retained as long as the patient 
is able. They may be composed of water alone, of salt and 
water, of gruel or oil, or of any of the purgative enemata 
contained in the Pharmacopoeia Br., their bulk varying from 
twelve ounces to a pint, and their function is not only to act 
mechanically by washing out the contents of the lower bowel, 
but to stimulate its peristaltic movements, which they do very 
efficiently. 

b. Those enemata which are intended for absorption, and 
which must, therefore, be small in quantity (3J-1J), so as not 
to excite the expulsive movements of the gut. The princi- 
pal of these is the enema opii, so highly prized on account 
of its restraining influence on the diarrhoea of typhoid and 
phthisis, and on account of the happy way in which it soothes 
pain, not only in the rectum, but, by nervous sympathy, also 
in the neighboring bladder and uterus. Astringents are also 
occasionally used in this way, whilst asafoetida, ipecacuanha, 
etc., find their special applications, which will be considered 
elsewhere, although we may here lay down the general rule, 
that drugs, with one exception(strychnine), act about half less 
powerfully by the rectum than by the stomach. 

Another mode of utilizing the absorptive power of the 
bowel is by suppositories, or pastille-shaped masses of medi- 
cated oil of theobroma, wax and lard, which are readily in- 
troduced within the sphincter ani, and where they readily 
melt at the temperature of the body. 

c. Nutrient enemata are of great service in cases where 
swallowing is prevented by cancer or stricture of the oeso- 
phagus, or where we wish to give the stomach, irritated by 
the presence of chronic ulcer, a thorough rest. The great 
difficulty, of course, is that the rectum, although it absorbs 
readily, has no digestive function, so that we must either 
compose our enema of very simple materials, or else add pep- 
sin and acid, or pancreatic fluid. 

Meat and pancreas enemata, formed of one pound of finely 
minced beef, free from fat or cellular tissue, with about three 
ounces of pancreas, kept a patient alive for nine months, and 
two to six ounces of freshly defibrinated ox-blood twice a day 
are said to have produced excellent effects in some cases 
where nourishment could not be taken by the mouth, the 

3* 



30 INTRODUCTION. 

combination of a grain or two of chloral preventing prema- 
ture decomposition. [The same object may be attained by 
nutrient suppositories with pepsin as proposed by Spencer.] 

3. We now come to the most widely used, convenient, and 
generally available mode of using medicines, by introduction 
into the stomach. Swallowing a dose at stated intervals in- 
volves far less trouble and general annoyance than the other 
plans we have just passed in review, and, after all, is of al- 
most universal application in ordinary cases. Occasionally, 
where patients will not or cannot swallow, we require to 
pump food, or drugs, artificially into the stomach, but, as a 
general rule, there is no difficulty on that score. It only 
remains for us now to consider the drawbacks we have to 
surmount. 

First. The patient is made fully aware of the too fre- 
quently nauseous taste of his medicine, and we must endeavor 
to conceal this by flavoring ingredients, by capsules, or other 
means. 

Secondly. Our drugs may spoil the appetite, injure the 
digestion, lower the tone of the system, cause nausea and 
depression, and general discomfort, and this we may partly 
avoid by timing their administration by judicious intervals. 

Thirdly. By coming in contact with various secretions, 
the remedy is much altered before it reaches the blood. The 
salivary, pancreatic, or biliary fluids, on the one hand, and 
the gastric juice on the other, must largely neutralize acid 
and alkaline remedies, whilst some drugs may be rendered 
partly inert by stomach digestion, or, like curare, may be 
eliminated too rapidly by the kidney to exert any poisonous 
influence when taken by the mouth. But we must also re- 
member that these and other actions give us substantial thera- 
peutic aid. The bile facilitates the absorption of our oily 
remedies, the gastric juice aids the solution and absorption 
of quinine and other drugs. Many purgatives only act effect- 
ually after previous solution in the alkali of the bile, etc. 

4. Drugs are occasionally injected into the bladder, but its 
absorptive power is very limited, if it exist at all, and it is 
usually only the mucous membrane which is locally attacked in 
this way by weak acids, alkalies, quinine, opium, and the like. 

The drug having now obtained admittance into the blood 
by any of the channels we have enumerated, proceeds either 
to exert its physiological action on the healthy processes of 
life, or to modify in various ways those deviations from normal 



RULES FOR PRESCRIBING. 31 

function which arc commonly called disease. It is impossible 
to reduce to any brief or tabular scheme the infinite varieties 
and gradations of power possessed by the principal remedies 
of the Pharmacopoeia, nor can we pretend to explain their 
selective tendencies : why sleep, and purgation, and vomiting, 
and a wide range of intricate nervous phenomena follow the 
introduction into the body of this or that substance. All we 
can do is to note these phenomena with discriminating care, 
to reduce them, when we can, to scientific principles, and then 
to consider their practical applications. 



GENERAL RULES FOR PRESCRIBING. 

Preliminary Considerations It will be well, be- 
fore proceeding further, that we should lay down some broad 
rules which may guide us in the construction of prescrip- 
tions ; and it seems best to introduce this subject here, in- 
stead of placing it, according to more usual custom, at the 
end of the book, as it is to be our aim and object to devote 
much care and attention throughout to the best modes of 
ordering drugs. Much professional credit may be derived 
from a good prescription, and as much damage done to the 
practitioner who orders for his patients mixtures which are 
neither agreeable to the eye nor palatable to the taste. It is 
well worthy of the student's attention to consider the most 
pleasant, effectual, and convenient way of ordering the drugs 
which are required by the sick, and at first he will no doubt 
consider this a very difficult task. This will partly depend 
on the fact that he has had the subject of doses and thera- 
peutical actions presented to him in such concentrated form 
that he will find some awkwardness in using practically the 
theoretical knowledge which lie has laboriously obtained. 
The time at his teacher's disposal is so short that he has to 
run hurriedly from one drug to another, and bring into im- 
mediate relation remedies which differ so widely in their 
effects as to excite some not unnatural confusion in the minds 
of his hearers. It is therefore not an uncommon thing to 
hear students say that they do not think they will ever be 
able to remember the doses of the principal medicines. 
Then we must, remember that, during attendance on out- 
patient practice, prescribing is either done on very routine 
principles, or considerations of time and convenience render 



32 INTRODUCTION. 

it advisable to order most drugs according to registered 
formulae, which are merely referred to on the patient's notes 
by name. Thus, although the student may know that dys- 
pepsia may be treated by mist. alk. amara, or debility by 
mist, quininre, he would perhaps experience some difficulty in 
writing a prescription suitable for either case. In the wards, 
of course, he sees much more prescribing, but is perhaps not 
very often called upon to do so himself, so that when he settles 
down on his own account it will be some time before he can 
handle medicines with that ease, confidence, and certainty 
which can alone conduce to the comfort of his patients and 
his own ultimate success. Now it cannot be out of place to 
urge upon him, here, the great importance of frequently exer- 
cising himself in his art. Let him put problems to himself, 
let him run his eye through his text-books, and endeavor to 
order the several drugs in varied combination ; when he 
meets with the recommendation to treat a certain disease in 
a certain way, let him there and then expand these more or 
less vague directions into the form of a prescription ; and so, 
at last, due blending of ingredients, with the avoidance of 
incompatibles and the concealment of nauseous properties, 
will come to him with perfect ease and efficiency. 

Another point, the mere mention of which may cause a 
smile, is the importance of occasionally inspecting, or even 
tasting, the mixtures we prescribe for our patients. Experi- 
ments of this nature will often do more to teach us the effi- 
cient combination of drugs than the most profound theoretical 
knowledge. It is by the experience gained in his own sur- 
gery that the country doctor is often found to order far more 
agreeable prescriptions than the hospital physician, and to 
steer clear of those hopelessly nasty concoctions which are 
occasionally sent out from the unwilling hands of druggists 
in obedience to the orders of scientific authority. 

1. Combination of Drugs The first things to be 

considered in writing a prescription are the object for which 
we order this certain combination of drugs, which symptoms 
in our patient's case do we wish to alter or modify, what is 
to be our principal ingredient, and in what quantity. These 
being duly settled in our minds, we reflect whether it is bet- 
ter to give this particular article by itself, or to combine it 
with other substances which may possibly assist, or mitigate 
its action, or may at all events conceal its more or less 
nauseous taste. Now it is a very commonly given recom- 



RULES FOR PRESCRIBING. 33 

mendation that in our prescriptions we should aim at sim- 
plicity as much as possible, and this certainly holds good 
within certain limits. The old-fashioned custom used to be 
to string together a long list of ill-understood substances, in 
the hope that some one or other of them might hit the right 
nail on the head, and even now traces of this polypharmacy 
linger about medical practice. When, however, we are tol- 
erably certain of the action of our drug, and more especially 
when we are making scientific observations on its mode of 
action, it is often of great importance that we should not 
obscure its effects by the addition of any other active sub- 
stances, but order it either simply in distilled water, or merely 
combined with other ingredients for flavoring purposes. But 
Ave must remember not to carry this principle too far. No 
fact is more thoroughly proved in therapeutics than the value, 
under certain conditions, of due combination, and the way 
in which one drug may assist the action of another. 

Thus, taking the case of diuretics, we know well that a 
prescription containing three or four members of this group 
will often act where one produces little or no effect, and that 
mercury is of undoubted service in assisting the influence of 
squill and digitalis over the urinary secretion. Cough med- 
icines are always best given in combination with a variety 
of drugs, and the same holds good of purgatives ; for we all 
know how hyoscyamus or belladonna will both aid and hold 
in check the action of colocynth, how a little sulphuric acid 
and iron will promote that of sulphate of magnesia, how jalap 
aids the peristaltic intestinal contractions to remove the watery 
fluid which cream of tartar drains into the bowels. 

Moreover, we all gladly acknowledge the advantage to be 
derived by the addition of a little iron to the digitalis which 
we give as a cardiac tonic, and to the ergot which is to stim- 
ulate the uterine functions, knowing, as we do, the important 
role which an improved blood supply necessarily plays under 
these circumstances. Narcotics also often gain in potency 
by combination, for do we not know that bromide of potas- 
sium and chloral together will occasionally cause sleep where 
either separately would have failed? Aromatics are often of 
great service in counteracting the griping tendencies of cer- 
tain active purgatives, and the success which has been 
claimed in some special conditions for Warburg's tincture 
over quinine, is held to be due to the peculiar way in which 
the action of the active ingredient is reinforced by the some- 



34 INTRODUCTION, 

what complicated farrago of substances by which it is sur- 
rounded. 

Arsenic is believed by some to prevent the unsightly acne 
produced by bromide of potassium ; and the best mode of 
obviating the discomfort of cinchonism consists in adding a 
little hydrobromic acid to our quinine. [The combination 
of a small amount of opium or morphine or quinine has been 
also found to prevent the occurrence of the disagreeable 
nervous symptoms that sometimes occur, and at the same 
time it increases the antiperiodic power of the drug, so that 
smaller doses may produce equal therapeutic effect.] 

Several alkaline medicines, given together, seem to act 
better in rheumatic fever than the simple administration of 
one member of the group. Tonics, such as quinine and iron, 
are blended with advantage. Then again, we add one drug 
to another for the purpose of counteracting some unpleasant 
physiological effect ; thus spiritus ammoniae aromaticus miti- 
gates the unpleasant symptom of iodism, and atropine lessens 
the chances of discomfort which attend the subcutaneous in- 
jection of morphine, and hydrobromic acid lessens the deaf- 
ness and ringing in the ears which are sometimes caused by 
quinine. Instances like this might be multiplied almost ad 
infinitum; but we shall develop the subject further as we go 
on, and refer frequently to the laws which should guide us 
in considering whether the various drugs are best ordered 
singly or in combination. 

2. Form of Administration We must take into 

consideration whether we ought to administer our drug in a 
concentrated or diluted form, and here again we shall find 
it necessary to act very differently under different circum- 
stances. As a general rule, we may lay down that the 
metals are best given either in pill or in a small quantity of 
fluid, and this remark applies more especially to those which 
have very active physiological properties. Thus we gene- 
rally give arsenic and perchloride of mercury [corrosive sub- 
limate] in a state of only moderate dilution. Salts, on the 
other hand, and more especially the purgative salts, act best 
when taken in large quantities of fluid, and we shall find in 
practice that iodide of potassium is decidedly more effica- 
cious when freely diluted, that sulphate of magnesium follows 
the same rule, and that in the case of diuretics also we may 
aid their action by combining the directly flooding or me- 



RULES FOR PRESCRIBING. 35 

chanically sluicing effect on the kidney oflarge quantities of 
watery fluid. 

3. Period for Exhibition The period of adminis- 
tration is also well deserving of careful study, and we may 
indicate one or two useful rules with regard to the action of 
alkalies and acids. As acids check acid secretions, and alka- 
lies have a similar influence over those with alkaline reaction 
and vice versa, we can readily understand the effect which 
they may exercise over digestion. Thus an acid given 
directly before a meal must interfere with the due assimila- 
tion of the nitrogenous articles of diet by checking the sup- 
plies of gastric juice, whereas an alkali given at the same 
time must theoretically produce the best results by stimu- 
lating that secretion. If, on the other hand, we give an 
alkaline medicine after food, we do harm by directly neu- 
tralizing the acid on which some part at least of the active 
principle of the gastric juice depends. 1 

Drugs which have a distinctly lowering or irritating effect 
on the system are best given with or after meals, so as to 
prevent these results as far as possible ; thus we always give 
arsenic or corrosive sublimate or strychnine at these times, 
and find that they are well borne by persons who could not 
take them on an empty stomach. For a different reason, 
again, we generally find it convenient to prescribe cod-liver 
oil after food, not only because it is less likely to cause sick- 
ness when given at that time, but also because oily matters 
being absorbed by the lacteals are most readily taken up 
when these structures are in full working order, and when 
they can be acted upon by the biliary and pancreatic 
secretions. 

Again, when we wish to imitate or excite a normal physi- 
ological action, we must time our drug accordingly. Opium, 
or any other narcotic, is much more likely to produce sleep 
when taken at night than at other times, and a mild purga- 

\} An important lesson for the student to learn at the outset is, 
not to place too great reliance upon his own a priori reasoning con- 
cerning the therapeutical effects of remedies. Drugs in many in- 
stances have more than one action upon the economy : for instance, 
the antiseptic influence of hydrochloric acid may be more efficient 
in gastric disorders than its simple acid reaction ; or the astringent 
effect of aromatic sulphuric acid may be especially serviceable. 
This therapeutic feature is entirely distinct from the varying effect 
produced by altering the size of the dose, which is considered fur- 
ther on.] 



36 INTRODUCTION. 

tive in the morning will often stimulate the peristaltic move- 
ment of the intestines to evacuate the bowels at the time 
when they are accustomed to act. Again, when we wish to 
re-excite a suspended menstrual flow, we will find our best 
chances of success in directing our remedies more especially 
about the time at which the monthly period ought naturally 
to appear. 

The efficacy of purgatives is also markedly aided by a due 
consideration of the periods at which they ought to be given. 
A resinoid cathartic principle contained in pill is usually of 
slow and deliberate action, and may be given indifferently 
with meals — as in the case of dinner pills — or on an empty 
stomach before bed-time ; but saline purgatives generally act 
best when given fasting, as the veins of the intestinal tract 
are then less full and more predisposed to rapid absorption. 
As an illustration of this we need only refer to the much 
more potent effect of an ordinary seidlitz powder given 
before than after breakfast. 

Anthelmintics, again, are always best given after as long 
a fast as possible, so that the parasites which they attack may 
not be shielded by food or mucus, and we find in practice 
that early morning is the most convenient period for their 
administration. 

4. Dosage The relative efficiency of large and small 

doses is the next point which has to be taken into considera- 
tion ; and here we are at once confronted by some of the 
most delicate and difficult questions in therapeutics — delicate 
because they border closely on the dangerous ground of 
homoeopathy ; difficult on account of their often unsettled 
nature. We cannot pretend to give any exhaustive discus- 
sion to this branch of our subject, because the materials for 
it are not forthcoming, but we can all contribute somewhat 
to its solution by experimental trials of various drugs given 
in these different ways. This much, however, we do know, 
that in many cases we get far more satisfactory results in 
special emergencies, or temporary conditions, by giving one 
tolerably large dose at one time ; and especially is this the 
case with narcotics, small quantities of which only excite 
and annoy, whilst a full dose satisfactorily brings about the 
desired result of sleep. Purgatives and emetics, again, are 
also best given in one considerable dose ; tonics, astringents, 
and diuretics require to be steadily repeated at certain short 
and regular intervals in order to have a sustained and con- 



RULES FOR PRESCRIBING. 37 

tinued effect. But the true point at which we wish to arrive 
is this : Can we best obtain rapidly and efficiently the con- 
stitutional action of a drug such as belladonna, or aconite, 
by administering in average quantities two or three times a 
day, or by ordering it to be taken in very small doses often 
repeated? Now, supposing we are called upon to treat a 
case of acute tonsillitis or catarrhal febrile disturbance, which 
we wish to remove as rapidly as possible, and we elect 
aconite as the special remedy to be used, the most reliable 
method for its administration is in drop or even half-drop 
doses every hour, half hour, or even ten minutes. General 
experience has pretty well confirmed this teaching, and has 
extended it to other medicines, such as prussic acid, which 
will thus more effectually control urgent sickness than when 
given at longer intervals in the more canonical way; to tar- 
tar emetic, which, in very small and often -repeated quan- 
tities, exercises a remarkable effect over infantile bronchitis; 
to ipecacuanha, which in minim doses will frequently check 
obstinate vomiting ; to calomel and gray powder, which in 
minute doses, every half hour, will often stop irritability of 
the stomach when nothing else will succeed. Instances of 
this sort will be multiplied as our consideration of the indi- 
vidual articles of the Pharmacopoeia goes on, the principle 
being steadily kept in mind that we may often bring the 
system much more efficiently under the special influence of a 
drug, by ordering it in small quantity often repeated, than 
by giving full doses two or three times a day; and this 
necessarily applies with special force to those drugs which 
are rapidly thrown out of the system, and whose action upon 
the structure or function they are particularly supposed to 
effect, is thus kept up and, so to speak, perpetuated, by very 
frequent administration. 

On the other hand, we must not forget that certain medi- 
cines must be given in very large quantities before their 
physiological properties are obtained. Thus it would be 
useless to expect succus conii to tranquillize irregular mus- 
cular movement in less doses than ijj ; [the succus conii has 
been dropped from the U. S. P. because its strength is va- 
riable.] Frequently we are required to give even more than 
this : belladonna is of no use in nocturnal incontinence of 
urine unless boldly pushed up to f3j or fjjss of the tincture. 
[In this connection it should be borne in mind that the 
British tincture of belladonna is only one-half the strength 
4 



38 INTRODUCTION. 

of that of the IT. S. Pharmacopoeia.] Arsenic acts best in 
chorea when prescribed with no timid hand. 

Another point of interest in connection with this inquiry- 
is, that drugs often display different and even opposing 
actions, according as they are given in large or small doses. 

Thus we have seen that drop doses of wine of ipecac will 
often check vomiting, whereas it is well known that a tea- 
spoonful, or even less, will almost immediately evacuate the 
stomach. Sulphate of zinc, in twenty or thirty grain doses, 
is prized as our best emetic, while it is equally established 
that from one to ten grains is a valuable nervine tonic, much 
used by some physicians in the treatment of chorea. 
[Quinine in doses of from two to five grains is a tonic ; from 
six to ten grains, a stimulant ; and in large doses is an anti- 
periodic and anti-pyretic] Small doses of opium excite, 
whilst large soothe into sleep ; half-ounce doses of infusion of 
digitalis may be more safely given than those of f 3j too fre- 
quently repeated ; the neutral salts of potash and soda are, 
as a rule, purgative in large, diuretic in small, doses ; and 
other instances of this principle — which will afterwards be 
given — must be borne in the mind of the prescriber before he 
can pretend to make most efficient use of the weapons at his 
disposal. 

5. The Interval between Doses. — The next head- 
ing to which reference is usually made is regarding how 
often we ought to repeat our dose of medicine ; but this is so 
far involved in what has gone before, that very little remains 
to be said. The ordinary rule is to order our mixture to be 
taken three times a day, or every four hours, unless special 
circumstances, such as we have already indicated, render it 
advisable to repeat more frequently. Although many sick 
persons look forward to the time of taking their physic, and 
feel moral as well as physical support from the mere act of 
attending to their doctor's order, the greater proportion are 
not so favorably impressed, and would willingly be relieved 
from the necessity of swallowing the often nauseous com- 
pounds they receive. Homoeopathists, no doubt, derive 
much of their success from the tasteless nature of their medi- 
cines, and we have not yet devoted sufficient attention to 
the elegances and refinements of pharmacy. It is well, 
therefore, to direct our tonics and astringents, and drugs 
whose action is to be spread over some considerable time, to 
be taken three times a day, always bearing in mind those 



RULES FOR PRESCRIBING. 39 

important exceptions which recent investigation has done 
such good service in impressing upon our attention. 

6. Individual Peculiarities ; Idiosyncrasy ; 
Habit. — When the student has been fairly emancipated 
from the leading-strings of his teachers, and enters practice 
on his own account, he will often be disappointed at the way 
in which drugs play their allotted parts. The necessarily 
cut-and-dried and dogmatic descriptions of the text-books 
have led him to believe that such and such a medicine will 
always act in a particular way, and he accordingly prescribes 
it with full confidence in a given case. But not only may 
the proper effects fail of development, but very unpleasant 
and almost unlooked-for symptoms may follow its use, which 
will be productive of much discomfort and uncertainty, and 
may even tend to shake his professional credit. The influ- 
ence of that strange individual peculiarity, usually termed 
" idiosyncrasy," and of which no reasonable explanation has 
ever been given, must be very carefully taken into account 
in prescribing, and we shall refer to it on all suitable occa- 
sions. Sometimes it renders our patient unduly susceptible 
to the action of drugs, and thus we may find one person 
seriously salivated by one grain of calomel, another who 
dare not touch quinine, a third who is furiously excited by 
opium, whilst a fourth may be poisoned by a single grain of 
morphine. Phosphorus and bromide of potassium also occa- 
sionally cause their peculiar effects in very small doses. A 
good precaution, therefore, is, before prescribing any of these 
drugs, to ascertain from the patient whether he has ever 
taken any of them before, and whether uncomfortable effects 
could be in any way attributable to their use. But, on the 
other hand, our patient's constitution may be such that very 
large quantities of drugs will alone succeed in acting ; and 
remarkable stories are told by Christison and others of the 
immense quantities of opium which persons, quite unaccus- 
tomed to its use, have been occasionally able to take with 
impunity. Purgatives act very differently on different peo- 
ple; and some require immense quantities of ancesthetic vapor 
before full insensibility is obtained. Although, as I have 
just said, we may often anticipate uncomfortable effects by 
due preliminary inquiry, it too often happens that they come 
on suddenly, and quite unexpectedly. Idiosyncrasy is so 
wide-spread and deep-rooted in the human constitution, in 
almost every function and action, that we can hardly hope 



40 INTRODUCTION. 

ever to obtain the key to its mysteries. Why, may be asked, 
do particular articles of diet disagree with special persons? 
Why does one person, on exposure to cold, take a simple 
catarrh, whilst a second becomes a prey to rheumatic fever, 
and a third escapes unharmed ? Why do we all differ from 
one another in some minor degree in almost everything that 
we do ? Until we can clear up these problems, it is vain for 
us to attempt to explain why we require to adapt our doses 
so carefully to individual constitution and peculiarity ; and 
the reason why the student is at first perplexed by all this is 
that we meet with these differences much more frequently in 
the upper ranks of society. The hospital or dispensary pa- 
tient swallows any dose, however nauseous, with much satis- 
faction, and is much less often affected by those troubles of 
irregular physiological action which so frequently harass the 
family medical attendant in more aristocratic circles. 

The power therefore, and a power unfortunately too often 
uncommunicable to others, of appreciating the peculiarities 
of different persons in respect of their " behavior" towards 
drugs, is just one of those " knacks" which go far to make 
up success in practice. We ourselves often wonder, or share 
the surprise of others, why certain doctors, whose scientific 
attainments may be none of the highest, attract and retain 
in a remarkable way the confidence of their patients ; and 
we may be sure that something beyond mere luck, or manner, 
or accident, is the true secret of their superiority. Tact in 
the use of remedies is no doubt in some degree the lever 
which has raised them to their positions, and more especially 
the power which well-remembered experience has conferred 
upon them of knowing intuitively, as we sometimes call it, 
what drugs will best agree with the individual sufferer. We 
yet know nothing of idiosyncrasy beyond the uncomfortable 
fact of its frequent and unsuspected existence, and, in pro- 
portion to our ignorance, all the more keen and persevering 
should be our search after those laws which must inevitably 
regulate its action. This it is which makes, and in the pre- 
sent state of our knowledge always must make, the deduc- 
tion from experiment on animals so often fallacious when 
applied to the human subject. I am far from wishing to 
undervalue the benefits conferred on our science by experi- 
ment, but we must remember that brutes have their idiosyn- 
crasies as well as ourselves, and, until both are thoroughly 
understood, therapeutics will lack much of the precision 



RULES FOR PRESCRIBING. 41 

which it must eventually attain. And for the further eluci- 
dation of our own eccentricities in this way we must mainly- 
trust to the labors of family doctors, and it is to be hoped 
that the Collective Investigation Department of the British 
Medical Association, which is now doing such good work, 
will eventually aim their attention to therapeutical problems 
and obtain from general practitioners some record of the ex- 
perience gained by them in their wide field of observation. 

The influence of habit on therapeutics is also worthy of 
every consideration, for we shall find in practice that medi- 
cines often lose their effect when continued for any length- 
ened period. More especially is this the case with opiates 
and narcotics generally, the dose of which requires to be 
gradually increased from time to time. Arsenic has the same 
peculiarity, as is shown in the case of the arsenic-eaters of 
Styria, who, by long continuance in the use of that sub- 
stance, are at last able to consume quantities which would 
inevitably prove fatal to a novice. And this leads to the 
question of toleration, an old-fashioned term dating from the 
days of heavy dosing with irritating metallic substances, but 
having sufficient bearing on modern practice to justify its 
consideration here. We have said that the term toleration 
savors somewhat of antiquity, because the great illustration 
of this principle used to be afforded by tartar emetic, which 
was then much more freely used in acute inflammations than 
now ; and when I say antiquity I do not refer to anything 
more remote than perhaps half a century ago. Then the 
contra-stimulant treatment of pneumonia was in full swing, 
and the curious fact became gradually known that, although 
the first doses of tartar emetic often caused much nausea and 
depression, subsequently larger quantities were well borne ; 
and this was explained by what was called toleration of the 
drug being established in the system. It will be seen, when 
we come to consider in detail the actions and uses of tartar 
emetic, that a very sufficient and scientific explanation can 
be given of this somewhat mysterious effect. In these days, 
inflammatory action is treated on somewhat different prin- 
ciples, and antimony is comparatively little used ; but the 
principle of toleration can be recognized in the use of other 
drugs. Thus, in dysentery, quantities of ipecacuanha are 
given which would infallibly produce violent vomiting in a 
healthy subject ; arsenic is better borne in skin disease than 
in a state of health ; choreic patients are able to swallow 

4* 



42 INTRODUCTION. 

almost emetic doses of zinc sulphate without the action of 
vomiting being induced. Digitalis is well known to be given 
freely in delirium tremens, and there is little doubt that the 
experiment of prescribing half an ounce of the tincture to a 
person in ordinary health would be productive of serious if 
not fatal consequences. Further instances of toleration might 
readily be adduced, but it will be much more to the ad- 
vantage of the student to recommend him to pick out other 
examples for himself than to provide him with a cut-and- 
dried list of all that is known on the subject. 

7. Accumulation. — We next come to what is com- 
monly known as accumulation, the theory of which is that 
certain drugs rest or become stored up in the system until 
they reach a dangerous quantity, when inconvenient or poi- 
sonous symptoms may result. Thus we know that after a 
certain continuance in the use of digitalis, faintness and de- 
pression have often been observed, that strychnine may cause 
uncomfortable twitchings after it has been taken for some 
time, that bromide of potassium only begins to cause annoy- 
ance when the system seems to have become saturated with 
the salt. Does this really mean that these substances have 
reached the point beyond which their poisonous action is 
neutralized, so to speak, by the symptoms which their thera- 
peutical powers attack, or is the defect in the organs of elim- 
ination which fail to expel them efficiently from the system? 
It is probable that both these and the numerous other ex- 
amples which our subsequent pages will contain depend on 
both these causes in some degree, in addition to another, and 
that is that the organ or tissue towards which the physiologi- 
cal action of the drug is directed is, after long- continued 
stimulation by repeated small doses, worked up into a certain 
condition of special excitement or depression, and discharges 
accordingly. Thus we find the twitchings from strychnine, 
the cardiac depression of digitalis, the nervous weakness and 
ataxy from bromide of potassium, the paralysis resulting from 
alcohol. The metals, as mercury, arsenic, etc., on the other 
hand, no doubt act by being stored up within the tissues, 
being brought into excessive action by some defect of elim- 
ination. 

And the practical outcome is, that in prescribing many of 
these drugs, and more especially digitalis, strychnine, and 
bromide of potassium, it is well to have an occasional break, 
to omit our prescription for a day or two, so as to give the 



RULES FOR PRESCRIBING. 43 

parts a rest, and enable the remedy to act afterwards with 
better effect perhaps in even diminished dose. It may happen 
that some of these uncomfortable effects are caused by defects 
in the organ of elimination, and it is therefore very impor- 
tant, when prescribing certain drugs, and more especially 
salicylic acid, to satisfy ourselves, by careful examination of 
the urine, that the kidneys are in thorough good working order. 

8. Chemical and Physiological Incompatibil- 
ities And now we come to the doctrine of incompatibility, 

which is of all-essential importance in therapeutics, consisting 
as it does of the principles which we require to know in 
order to avoid that amount of clashing of the different ingre- 
dients of our prescription which may either alter or destroy 
their action. Now incompatibility maybe of different sorts, 
and is generally divided into chemical and physiological. Of 
these we will first consider chemical incompatibility. 

This consists in the chemical action of one drug on an- 
other, which may result in the formation of a new compound 
when they are mixed. Thus the addition of iron to decoc- 
tion of cinchona will produce an unsightly, black mixture ; 
strychnine and perchloride of mercury will not go with gela- 
tine ; sulphuric acid and lead form an insoluble sulphate. 
A good deal of this incompatibility, however, is inconvenient, 
principally, because the resulting solution is often thick, tur- 
bid, and unsightly, and therefore repugnant to the patient. 
Many most incompatible mixtures are therapeutically effi- 
cient, and some are even prescribed deliberately. Quite 
otherwise is it, however, with the second group, or the phy- 
siological incompatibles, the rationale of which is that the 
action of one drug is so far antagonistic to that of another 
that the mixture of the two is necessarily inert. Thus the 
combination of belladonna and opium is in some degree op- 
posed, so is atropine and prussic acid, aconite, and digitalis, 
strychnine and Calabar bean, and most markedly of all, 
caustic alkalies with belladonna, hyoscyamus, stramonium, 
or tobacco, all of whose active principles are thus absolutely 
destroyed. 

But, as already hinted, we often prescribe an incompatible 
mixture for t,he purpose of actually deriving therapeutic ad- 
vantage from the resulting compound. Thus what is a 
more generally used and, I may confidently say, more useful 
prescription than bichloride of mercury and iodide of potas- 
sium, making an iodide of mercury, which is much more 



44 INTRODUCTION. 

efficacious than that salt itself as prepared by more elaborate 
chemical agency ? T Again, the far-famed mist, ferri co. de- 
rives much of its charm from the freshly prepared carbonate 
of iron which results from the due combination of ferric sul- 
phate and pottassium carbonate. Black wash is another 
example ; and although corrosive sublimate and decoction of 
bark are undoubtedly incompatible, no better means is known 
of counteracting the depressing effects of this preparation of 
mercury. 

[Some of the principles of incompatibility, as applied to 
the writing of prescriptions, may be conveniently formulated 
as follows : — 

General Principles of the Incompatibility of drugs. — 1. 
As a rule a drug is incompatible with its antidotes and its 
chemical tests, especially if the latter depend upon the form- 
ing of an insoluble precipitate ; thus metallic salts or albumen 
should not be prescribed with substances containing tannin, 
nor chlorides with nitrate of silver. Therefore, in combining 
soluble salts with each other, or with infusions, be careful 
to see that an insoluble precipitate is not unintentionally 
formed. 

2. The alkaloids are precipitated by tannic acid and 
caustic alkalies, and may be destroyed by chlorinous com- 
pounds. 

3. The alkalies, as a rule, precipitate metallic salts, and if 
caustic, may render vegetable active principles inert. 

4. Mineral acids decompose salts of vegetable acids, and 
other salts where they have a superior affinity. They form 
ethers with alcoholic preparations. 

5. The glucosides, such as salicin, santonin, and colocynth, 
are decomposed by free acids, or emulsin. 

6. Tinctures in general deposit resin on adding water, 
which also precipitates iodine from its alcoholic solution. 
Infusions containing tannic acid are incompatible with me- 
tallic salts generally. 

Special Incompatibles. — In accordance with the first rule 

[} It is true that these salts in solution are chemically incompat- 
ible, as a reaction takes place, and a precipitate is formed. This 
precipitate, however, is soluble in an excess of potassium iodide, 
forming a new chemical compound, which may be looked upon as 
an iodo-hydrargyrate of potassium, dissolved in a solution of potas- 
sium chloride, with perhaps other compounds not positively deter- 
mined.] 



RULES FOR PRESCRIBING. 45 

given above, the table of antidotes placed at ibe end of the 
book will for the most part suggest the individual incompat- 
ibilities. 

The following should as the rule be exhibited alone, or 
simply dissolve in distilled water : corrosive sublimate, tannic 
acid, strychnine, preparations of lead and of iodine, and nitrate 
of silver. With glucosides, or creasote, silver nitrate forms 
an explosive compound, and it should never be prescribed in 
pill with vegetable extracts. 

A mixture of chromic acid and alcohol is explosive, and 
so is chlorate of potassium, when powdered with sulphur or 
tannic acid. 

Aromatic waters sometimes precipitate metallic salts, on 
account of containing a small amount of carbonate of mag- 
nesium. 

Syrup of squill and of garlic contain free acetic acid, and 
are incompatible with carbonates. 

Tincture of chloride of iron precipitates quinine from the 
solution of quinine sulphate, but to some extent redissolves it 
when in large excess. 

Solution of acacia gelatinizes with tincture of the chloride 
of iron and with borax. It is precipitated by a solution of 
subacetate of lead, and by alcohol.] 

9. Prescribing for Children. — A few words may 
now be said on the art of prescribing for children, a subject 
which is only incidentally touched upon in our ordinary 
books, and is then treated in a somewhat misleading manner. 
Elaborate tables have, however, been drawn up for the regu- 
lation of doses according to age, and in all of these it is 
assumed that young children necessarily require much 
smaller doses of most drugs than adults; and this is true in 
so far that it is seldom advisable to deal out our mixtures to 
them in the time-honored tablespoonful or two tablespoon- 
fuls of their elders. But the important fact which these sys- 
tems invariably ignore is this, that children can often take, 
not only with impunity, but even with decided benefit, quan- 
tities of some active remedies which will correspond to the 
full adult dose. And the reason of this may be looked for in 
the much greater destruction and construction of tissue in 
early life, whereby the organs of elimination are in unusual 
activity, and hence disposed to excrete medicinal substances 
with special promptitude. "Whether we accept this explana- 
tion or not, however, we may warn the young practitioner 



46 INTRODUCTION. 

that an adherence to the rules usually laid down for children's 
prescriptions will cause him serious disappointment, and that 
he will be surprised at the beneficial results which will often 
follow the adoption of a bolder course. 

To furnish a few examples of this proposition, we will 
begin with belladonna, which may be used very freely in 
childhood, and the dose of which we have pushed, in a child 
of ten years of age suffering from incontinence of urine, to 
f 3 U (Ph. B.), 1 with good effect, and the development of only 
very mild forms of physiological disturbance. We commonly 
begin with n^xx in a child of two or three, and have pre- 
scribed n^x in an infant of six months with remarkable bene- 
fit ; and the result of my experience undoubtedly is, that 
children bear belladonna actually better than grown-up per- 
sons, and that in them really poisonous symptoms rarely if 
ever occur. 

Arsenic may also be freely given to children, and, at the 
age of five or six, I should have no hesitation in beginning 
with n^v [of Fowler's solution] and pushing even up to n^x 
if necessary. Strychnine is also well borne. Tinct. ferri 
chloridi may be taken in large quantities, and I have seen 
excellent results follow the administration of f3J ter die, in 
a little girl of six years. 

Children will often require large purgative doses, more 
especially of pulv. jalap. co.,and of ipecacuanha as an emetic. 
I have often ordered quantities which have startled the dis- 
penser, and induced him to come for explanation under the 
idea that I had made a mistake. Bromide of potassium may 
also be freely given, and other instances will be noted as we 
go on. We should always remember the sound old advice to 
be very careful with opium at an early period of life. Every 
practitioner has no doubt seen cases in which ill results have 
unexpectedly followed laudanum prescribed before the age 
of one year, and I cannot do more than reiterate the warn- 
ings on this subject which every manual of materia medica 
most properly contains. The explanation of this possibly 
enough may be, that the open fontanelles of early childhood 
permit a much more sudden and effective increase in the 
quantity of blood contained within the skull than in adult 
life. Some confirmation of such an opinion may be found in 

[' The tincture of belladonna of the British Pharmacopoeia is about 
one-half the strength of that of the U. S. P.] 



RULES FOR PRESCRIBING. 47 

the fact that very young infants will usually bear large doses 
of those narcotics which act by causing anaemia of the brain, 
and notably of chloral hydrate, which I have prescribed with 
benefit in five-grain doses thrice a day to a little child only 
twelve months old. It is important to remember that below 
the age of one year bromide of potassium is ill-borne by chil- 
dren having a tendency to cause a pustular rash, and it is 
also well to be cautious in using iodide of potassium at this 
early age. 

It is always well to make our dose as small as possible, 
one or two teaspoonfuls being usually sufficient, and great 
pains must be taken, by means of well-adjusted flavoring in- 
gredients, to disguise the too often nauseous taste of our 
drugs. Various syrups and aromatic waters here stand us 
in good stead, and it is well if possible, when dealing with 
very young infants, so to reduce the bulk of the medicine as 
to enable it to be mixed unobserved with milk, veal-broth, 
beef-tea, or some sort of confection. In this there is nothing 
really antagonistic to the principle which has just been 
developed, as we can readily enough give considerable quan- 
tities of belladonna, arsenic, etc., in comparatively small 
quantities of water, or even in none at all. 

Children are, however, somewhat strangely capricious in 
their taste; for whilst they object decidedly to bitter or acid 
substances, they will take oils readily, and generally seem to 
derive satisfaction from sucking in cod-liver oil. Nauseous 
powders which would seem inexpressibly revolting to their 
elders, they often take well, and by a little contriving and 
consideration we can generally manage to persuade them to 
consume their dose with philosophic composure, if not with 
actual relish. 

We may now briefly consider two very interesting 
points : — 

First, the effects of drugs administered to a nursing mother 
on the child. Of this, of course, we have ample evidence, 
knowing, as we do, of the elimination of many medicines 
by the milk, such as iodide and bromide of potassium, rhu- 
barb, and lead. We often find that infants are griped and 
made uncomfortable by their mother's medicine, and we 
must remember this in prescribing, even if we are allowed 
to forget it by the patients themselves, who are usually well- 
informed on this point. But little advantage has hitherto 
been taken of this way of treating young children, and it 



48 INTRODUCTION. 

seems hardly admissible to recommend a larger recourse to 
so roundabout a plan, as some of the substances used in this 
way might check the secretion of the milk by impairing the 
health of the mother, and as there is no real difficulty in 
giving effective doses of therapeutic agents to children even 
at so early an age. 

When we come to number two, however, some interesting 
speculations are encouraged, for we have to consider in how 
far we can modify or affect the condition of the fetus in 
utero by drugs administered to the mother. There is no 
doubt that a strain of syphilitic infection has been arrested 
by mercury given to the mother during pregnancy, and that 
the infant thus vicariously treated was the first out of a long 
series which proved to be free from all specific taint. Iodine 
and salicylic acid, quinine, santonin, and nitrate of potash 
have been detected in the urine of the fetus whose mother 
had taken those substances, and Dr. McClintock, of Dublin, 
records six cases in which the regular recurrence of abortions 
was checked by giving iron and chlorate of potassium 1 to the 
mother. 

It is probable that drugs given to the mother at the time 
of labor are more liable to injure the child than during the 
period of pregnancy, because of the interference with the 
eliminating function of the placenta. 

10. Prescription Writing TVe next come to the 

construction, or what we may call the anatomy, of the pre- 
scription itself, how it is put together, and how its compo- 
nent parts are arranged ; and we commence with the * R' 
with which it begins, and which really means an old invoca- 
tion to Jupiter. But, conventionally, it has been held to 
imply the verb recipe, which governs the quantity in the 
accusative, the name of the" medicine being put in the geni- 
tive. Thus, Recipe (take) pulceris (of powder) scammonice 
(of scammony) scrupulam (a scruple), etc. Other direc- 
tion are laid down in books which deal with this question, 
and much valuable information is contained in Pereira's 
i Selectee Praescriptis' and the clear and instructive little 
work of Dr. Griffith, of Dublin ; but it is hardly necessary 
to reproduce these here, as students beginning their medical 
curriculum are presumably sufficiently well grounded in 
classics to enable them to understand the very moderate 
amount of Latin required for their use in prescribing. Asa 

1 Brit. Med. Journal. 



RULES FOR PRESCRIBING. 



49 



rule, most medical men write their directions nowadays in 
English ; and this has not only the advantage of limiting the 
chance of mistake, but it does away with much of that mys- 
tery which beyond anything else has tended to keep back 
the progress of our art. In these enlightened times, when 
even more than a smattering of physic is commonly possessed 
by the laity, we do not find our patients quietly consenting 
to be kept in the dark as to what medicines they are taking. 
Rather we find them showing a keen interest in our pre- 
scriptions, anxious to inquire, and argue, and, if possible, un- 
derstand all about the line of treatment we have determined 
to pursue. The cases are very rare in which it is necessary 
to conceal from them the presence of any particular drug in 
their mixture, and Latin directions are therefore not only 
unnecessary, but pedantic in the highest degree. It is still, 
however, the custom at examining boards to ask the candi- 
dates to write and read prescriptions fully constructed ac- 
cording to this custom, and in the prescriptions which we 
shall frequently add to our descriptions of the various drugs 
we shall invariably give the directions in Latin of the usual 
form. 

11. Weights and Measures. — It only remains for 
us, then, to add the signs and symbols in general use, which 
are as follows : — 



gr., granum 
9, scrupulum (scruple) 
%, drachma (drachm) 
§, uncia (ounce troy) 
5), libra (pound) . 

TTl, minimum (minim) 
f J, fluidrachma (fluid 

drachm) 
f^, fluiduncia (fluid 

ounce) 
0, octarius (pint) . 

C, Congius (gallon) 



3 scruples = 

8 drachms = 

12 ounces troy = 



1 grain. 

20 grains. 

60 grains. 

480 grains. 

5760 grains. 

... 1 minim. 

60 minims. 

8 fluid drachms = 4S0 minims. 
16 fluid ounces, 

U. S. P. = 7680 minims. 
8 pints . = 61440 minims. 



In the British Pharmacopoeia the time-honored drachm 
and scruple weights have been discarded, and all who pre- 
scribe or dispense medicine are recommended to discontinue 
their use ; but old-fashioned customs are not so readily 
swept away, and we accordingly find these most convenient 
terms flourishing as much as ever. In domestic practice we 
5 



50 INTRODUCTION. 

find a much more rough-and-ready mode of prescribing, the 
generally received measurements being as follows : — 

Drop (usually about £ minim) = gtt., gutta. 

Teaspoon ful . . . .= 1 fluid drachm. 

Dessertspoonful . . : " . = 2 fluid drachms. 

Tablespoonful . . . = 4 fluid drachms. 

Wineglassful . . . = 1^ to 2 fluid ounces. 

Teacupful . . . . = 5 fluid ounces. 

Breakfast-cupful . . . = 8 fluid ounces. 

Tumbler . . . . = 10 to 12 fluid ounces. 

Of all domestic modes of measurement, however, none can 
equal the drop in fallacy and danger. The size of the drop 
is influenced first by the shape of the bottle, and secondly by 
the quality of the fluid itself, and hardly any two substances 
will be found to contain the same number of drops in a given 
quantity. 

Tablespoons, teaspoons, and all domestic measures are 
most absurdly variable in size, and we shall do well steadily 
to discountenance their use in all cases, and to insist that 
our patients shall carefully regulate their dose by means of 
those graduated glasses which are within the reach of all but 
the very poorest. 

Although it would manifestly be lulling our readers into a 
false security, were we to attempt to lay down any absolute rules 
respecting dosage, we may venture to state some broad prin- 
ciples which will help the memory. Students often complain 
of the great difficulty they experience in remembering doses, 
and at first sight it would appear a most irksome task for a 
person not in the habit of prescribing to carry in his mind 
the major and minor quantities of drugs which he may safely 
order. But by giving a few rules, and adding exceptions, 
as in the Latin grammar, we hope to show that there is no 
real difficulty here, but that we may safely group substances 
in such a way as to associate their doses with one another 
with tolerable simplicity. But first let me say one word 
about the British Pharmacopoeia. Constructed as it was by 
official authority several years ago, it is naturally looked 
upon as our vade mecum, and every student is supposed to 
possess a copy, and to make himself familiar with its con- 
tents. In the first edition no doses were given, and in the 
next, although these were added in deference to a universal 
request, it was expressly stated that they were not to be con- 
sidered authoritative, or specially enforced by the Medical 



GENERAL PLAN OF ARRANGEMENT. 51 

Council. But the Pharmacopoeia being the only official 
guide, has now been forced into a position respecting dosage 
which its framers did not intend or desire, and we accord- 
ingly find that in any case of difficulty its authority is 
invariably appealed to. It lies on every druggist's counter, 
it is the standard in courts of justice, and, this being the 
case, it ought to reflect the most advanced researches on its 
subject. But this is not so ; on many points its recommen- 
dations are hopelessly at variance with modern practice, and 
we are hence exposed to the annoyance and possible dis- 
credit of having our prescription sent back or cut down by 
druggists who are afraid of exceeding the dose sanctioned by 
authority. Thus the maximum dose of succus conii is fixed 
by the Pharmacopoeia at f 3j, of quinine at gr. x, digitalis 
f 3j ; and when we come to consider the various substances 
in succession, we shall find many other examples of a dis- 
crepancy between our teaching and its statements, which this 
explanation will clear up. [These difficulties are avoided 
in the United States Pharmacopoeia, the doses of remedies 
being judiciously omitted.] 

We may now proceed to indicate the natural system of 
grouping, by which some order may be given to the arrange- 
ment of the doses of drugs in the already crowded brain of 
the student or the young practitioner. 

Thus let him remember that, as a general rule, tinctures 
may be prescribed in doses of from n^x to f'3j, infusions 
and decoctions from f §ss to ^ij, powders from two to ten 
grains, pills four to ten grains ; and although there are nu- 
merous and very important exceptions to this, the recollection 
of the principle will spare us from the drudgery of placing 
the exact dose after every preparation whose action we shall 
examine. 

[The following are some of the important exceptions to 
this rule : — 

Infusum brayerae, U. S P. Tinctura nucis vomicae, U. S. P. 

" digitalis, 
Tinctura aconiti, 

" belladonnas, 

" cantharidis, 

" capsici, 

" digitalis, 

" iodi, 



opn, 
" acetata, 
" deodorata, 

physostigmatis, 

scillae, 

stramonii, 

veratri viridis, 



ipecacuanhas et " pyrethri is only used 

opii, " externally.] 



52 INTRODUCTION. 

These rules may be borne in mind in a general way, and 
we shall now go on to consider very briefly the plan of 
arrangement to be pursued when we come to consider the 
various medicinal substances seriatim. Our object will be 
to balance, as far as possible, their physiological against 
their therapeutical action, arranging them in corresponding 
columns in diagrammatic form ; and it will greatly assist this 
arrangement, as well as aid the memory of the student, if we 
adopt the following order in stating what we know respecting 
the properties of each drug. 

Take, first, its local or external action. 

Then its influence on the brain and on the spinal and sym- 
pathetic system of nerves. 

This will lead us up gradually to the effects on the heart 
and bloodvessels, whose functions are presided over and 
ruled by nervous influence. 

The effects of the drug on respiration and temperature will 
next be considered, and we then proceed to the alterations 
of secretion in the following order, urinary, intestinal, sali- 
vary, cutaneous, etc. 

' Then other actions which come under no heading, and 
which may be called specific. 

Finally, we must consider the various modes of elimina- 
tion from the body, the antidotes, contra-indications, and 
best modes of prescribing ; winding up, in most cases, with a 
prescription which will, as far as possible, combine efficiency 
and elegance with palatability. 

Regarding the method in which the following pages will 
be arranged, a few words may be said. 

Different modes of grouping drugs have been adopted, and 
by some the preference is given to the purely physiological 
plan, by which all the medical substances having a particular 
action are placed under that special heading ; thus, we have 
puigatives, narcotics, astringents, etc., as different varieties, 
with their attendant species. No doubt such a plan has the 
merit of scientific precision, and, had each drug only one 
medicinal action, nothing could be simpler or more effective 
than this arrangement, of which Neligan is the chief expo- 
nent. But an unfortunate element of complication is intro- 
duced by the fact that one drug may act in many, and indeed 
opposing, ways. Thus, whilst opium is an astringent, it has 
every right, under certain circumstances, to be called a pur- 



GENERAL TLAN OP ARRANGEMENT. 53 

gative ; its stimulant action is as evident as its narcotic ; it 
is a diaphoretic, a sedative, an antiphlogistic ; and the con- 
fusion inseparable from hunting it about among its various 
headings must necessarily be perplexing to the mind of the 
student, as well as occasion loss of time. Many other drugs 
behave in the same way, so it has been thought best to adopt 
the arrangement of Garrod and other popular text-books, in 
which the inorganic substances are placed alphabetically, and 
the organic in accordance with the natural orders to which 
they belong. We shall only venture to make one modifica- 
tion, and that will be to remove the general principles of 
therapeutics from their usual position at the end of the book, 
and scatter their classification systematically through our 
pages. For instance, after treating of the leading member 
of the purgative or narcotic group, we shall use that as a peg 
on which to hang a general description of that class of sub- 
stances in general, and in this way we may hope to relieve 
that tedium which is apt to arise when too many deductions 
and generalizations are presented en masse. The brief space 
necessarily at command in the following pages, and the dog- 
matic tone so necessary for teaching, may possibly tend to 
create in the mind of the reader an undue confidence in the 
curative power of drugs. Unhappily we cannot emulate the 
confident faith of homoeopathists, who label their tinctures 
and globule bottles with the names of special diseases which 
the contents are believed infallibly to cure. We have as 
little admiration for this overweening confidence as for the 
scepticism of some modern writers, who would fain have us 
believe that drugs have no influence over the processes 
of disease. Nothing can be more paralyzing to progress 
than this tone of thought, and we should recommend to 
our readers in preference an excess of faith, and an earn- 
est determination to work out the clinical bearings of thera- 
peutics. 

Experiments on animals have done good service ; and we 
have only to point to the brilliant researches of Rutherford 
in proof of this assertion ; but what is even more wanted are 
accurate and extensive trials of drugs in practice by well- 
instructed general practitioners. Extended and well-recorded 
observations from the wide field at their disposal will not 
only be cordially received by the profession, but will be of 
real service in giving us data from the only sure basis on 

5* 



54 INTRODUCTION. 

which we can build up our opinions and practice with refer- 
ence to the real actions of* drugs. 

Convinced although I am of the great importance of drug 
treatment in many diseases, one of the first lessons to be 
learnt in practice is the infinite value of careful watching 
and nursing, feeding, and general hygienic arrangements. 

The importance, for instance, of free ventilation, of open 
windows without draught, of fires as ventilating agents, of 
the prompt removal and disinfection of all discharges, of 
quiet, firm, and skilful nursing, of well-arranged bedding, 
including quiet, and the careful exclusion of the beams of 
early morning light, are points of importance only to be 
thoroughly appreciated by the practitioner. 

The well-instructed medical man will do well to make 
some little study of cookery, so as to devise and even super- 
intend dainty dishes for the sick, as well as to see that the 
beef-tea is clean and strong, and the general dietary varied 
and appetizing. He must remember the necessity for for- 
bidding solid food in acute disease, but most especially in 
acute rheumatism and enteric fever, the evil influence of 
starch or sugar in diabetes, of an excess of nitrogenous or 
saccharine articles of diet in rheumatism and gout. And 
when the acute symptoms have gone by, and convalescence 
is established, he must be able to recommend to his patient 
the best form of change of air; of foreign* spa or bath, of 
Swiss or Scottish air, unless he is prepared to lose caste at a 
time when such knowledge seems of greater value than even 
the more special familiarity with drugs proper. 



[THE METRIC SYSTKM IN MEDICINE. 1 

In order to translate our prescriptions into the metric sys- 
tem when so desired, it is only necessary to bear in mind 
that the Gramme or unit of weight is equal to nearly 15^ 
grains (troy), and that a gramme of water occupies the space 
of a cubic centimetre. The relation therefore between the 
two systems would be as follows : — 

1 For further details, see Weights and Measures at the end of 
the book. 



THE METRIC SYSTEM IN MEDICINE. 55 

OLD STYLE. METRIC. 

Ti\ j or gr. j equals ....... |06 Grin. 

f3Jor3J " 4 

f^jorjj " 32| 

A teaspoonful is usually 5 Gms. ; a tablespoonful 20 Gms.] 



REMARKS 

ON 

CERTAIN CLASSES OF REMEDIES. 



ACIDS. 

AVe will first take up the consideration of acids, and, before 
enumerating the therapeutic properties of each individual 
member of the group, it will save time and repetition if we 
draw attention to the collective actions and uses of acids in 
general. 

External Action. 



Physiological. 

Acids, being possessed of 
high diffusive power, rapidly 
permeate tissues to which 
they may be applied, coagu- 
lating their albumen, and, if 
concentrated, absorbing their 
watery constituents and caus- 
ing their destruction. 



Therapeutical. 

Acids, if used in concen- 
trated form, therefore, act as 
caustics, eating away and 
destroying animal tissues. 
When more diluted they are 
astringents, hardening and 
constringing weakened parts 
and checking unhealthy se- 
cretions. 



Internal Action. 

1. On Circulation. — All 
the acids have the pro- 
perty of increasing the 
of the blood, probably 



acids 

rather by setting free another 
acid than by a direct action 
on that fluid ; for by the time 
they enter the circulation 
they are themselves converted 
in great measure into salts bv 



1. The action of acids in 
checking hemorrhage is thus 
explained, as there is no doubt 
that coagulation is encouraged 
by an acid condition [or a 
decreased alkalinity] of the 
blood. 



ACIDS. 



57 



the various alkaline secre- 
tions with which they have 
come in contact. 

2. They may also contract 
the smaller bloodvessels by 
reflex action, or by directly 
astringing them locally. 

[In fever they relieve 
thirst and tend to reduce the 
temperature.] 



3. Their action on secre- 
tion is interesting, and has 
been specially pointed out by 
Ringer. It appears that an 
acid applied to the orifice of 
a gland secreting an acid fluid 
w r ill check that secretion, and 
thus any member of this 
group taken into the stomach 
before or at the beginning of 
the process of digestion will 
tend to act unfavorably by 
stopping the flow of gastric 
juice. 

[The inorganic acids do 
not favor fermentation, and 
some of them, like hydrochlo- 
ric acid, sulphurous acid, and 
carbolic acid, are decidedly 
antiseptic] 



2. They are useful in ex- 
ternal hemorrhage, and to 
check excessive perspiration 
[or abnormal discharges]. 

[Salicylic acid has been 
used as an antipyretic, and es- 
pecially in acute rheumatism, 
with decided benefit. Acid 
drinks are grateful to fever 
patients.] 

3. This physiological action 
points to a valuable bearing 
on therapeutics. Some cases 
of dyspepsia depend on a de- 
ficient production of gastric 
juice, enough of this fluid 
not being secreted under the 
stimulus of food to dissolve 
and digest the albuminous 
constituents. This condition 
may be remedied by mechan- 
ically supplying the want by 
a little acid given some time 
after food. But again, still 
more cases of disordered di- 
gestion are caused by an ex- 
cessive formation of gastric 
juice, the surplus supply of 
acid teasing and worrying 
the mucous membrane of the 
stomach, and causing pain, 
sour eructations, and general 
distress. Here our physio- 
logical law comes into play, 
and we check the over-secre- 
tion by giving the acid im- 
mediately before the meal. 
Or again, discomfort may re- 
sult from irregular or exces- 
sive fermentation of food, 



58 



ACIDS. 



But if acids arrest secre- 
tions having their own chem- 
ical reactions, they stimulate 
those which are alkaline, 
markedly increasing their 
quantity. Thus we find that 
they tend to promote the flow 
of the saliva, of the bile, and 
of the pancreatic secretion. 



On the Urine Inorganic 

acids increase the acidity of 
the normal urine, but have 
no power of rendering an al- 
kaline urine acid. The pro- 
perty is alone possessed by 
benzoic and citric acids. 

4. Acids, by their astring- 
ent properties, brace up re- 
laxed mucous membranes, 
and check unhealthy secre- 
tion. 



giving rise to the formation 
of a large quantity of acetic, 
butyric, and lactic acids ; and 
this undue fermentation is 
found to be itself directly con- 
trolled by acids given in this 
case after food. Possibly some 
of their influence in checking 
acid perspiration may be due 
to this law. 

We can thus explain what 
has been called the refrige- 
rant action of acids, or their 
undoubted influence in reliev- 
ing thirst and imparting a 
fictitious sensation of cool- 
ness. By stimulating the se- 
cretion of the salivary glands, 
we moisten the dry, parched 
mouth of our fever patient, 
and quench his thirst perhaps 
better than in any other way. 

It is probable also that 
some at least of the beneficial 
influence exerted by acids on 
chronic biliary derangement 
is due to their directly in- 
creasing the flow of alkaline 
fluid from the liver. 

4. They are, therefore, 
good tonics, and act well in 
diarrhoea and profuse sweat- 



DlSADVANTAGES. 

The prolonged use of acids is apt to exercise a very un- 
favorable influence on digestion, rendering persons pale and 
languid, and causing a good deal of emaciation. This was, no 
doubt, the secret of the action of vinegar in reducing corpu- 
lence, which used to be so highly prized in the Byronic days, 
and by incautious indulgence in which so many ignorant 
people have at various times ruined their health. 



ANESTHETICS. 59 



Poisonous Effects. 

The symptoms consist of very violent burning pain in the 
stomach and intestines, vomiting, purging, intense prostra- 
tion, and death either by shock or from the results of secondary 
inflammation. On post-mortem examination, intense inflam- 
mation of the stomach and intestines is found, with ulcera- 
tion of the mucous membrane, and even perforation into the 
peritoneal cavity ; and if the case is of a more lingering cha- 
racter, fatty degeneration of various internal organs, but 
more especially of the kidneys, becomes gradually developed. 
[The treatment of poisoning is to be found under the respec- 
tive heads, according to the acid employed.] 



ANAESTHETICS. 

For a full discussion of the physiological and other prop- 
erties of anaesthetics the reader is referred to the subject of 
Ether, Chloroform, and Nitrous Oxide Gas in the succeed- 
ing section. The consideration of their relative value, as 
stated by Dr. Clover, may be here briefly considered under 
the head of 

The Choice of Anaesthetics. 

" For ordinary surgical cases ether is safer than chloro- 
form. 

" The length of time needed to get a patient under ether 
is no longer a difficulty. Within the last four or five years 
the use of ether has increased rapidly in England in conse- 
quence of the adoption of better methods of administering it. 
Formerly the ether was given so abundantly as to excite 
choking and violent struggling. Now, methods which pro- 
duce a certain degree of asphyxia by preventing the access of 
fresh air, and allowing the same air to be breathed over and 
over again, are generally adopted. By causing this degree 
of asphyxia, the patient is made to take deep and frequent 
respirations which carry the etherized atmosphere down to the 
lung-cells. The atmosphere is thus made effective without 
being so strong as to cause local irritation. The least 
unpleasant way of inhaling ether is to begin with laugh- 
ing-gas only, and then introduce ether-vapor gradually 



60 ANTHELMINTICS. 

•along with the gas, without allowing any fresh air to be 
admitted. 

" Chloroform is most suitable for children and for aged per- 
sons with brittle arteries, also for sustaining the anaesthesia 
during protracted operations inside the mouth. In some cases 
of operation on the eye, when it is desirable to diminish the 
hemorrhage, chloroform is better than ether. In midwifery 
practice the same may be said. 

" Laughing-gas is best for ordinary tooth-extraction, for re- 
ducing luxations or moving stiff joints, for opening abscesses 
and fistulas, and other cases where anaesthesia is required only 
for a short time. For those operations which last from five 
to fifteen minutes it is found that laughing-gas, followed by 
a small quantity of ether, and a very limited supply of fresh 
air, is the anaesthetic least often attended by sickness. The 
recovery of sensation is, however, much more rapid than 
when chloroform or ether alone has been used to the same 
effect, and where great pain is expected to result, a hypo- 
dermic injection of morphine is also needed. 

" The mixture of nitrite of amyl with chloroform has been 
strongly advocated by Dr. Sandford, an American physician. 
I have tried it in a dozen cases, and find that it produces 
insensibility rapidly, and, if the anaesthetic is then removed, 
the recovery is very satisfactory ; but when the inhalation is 
continued for three or four minutes there seems to be nearly 
as much subsequent depression and nausea as if pure chlo- 
roform were given. The nitrite has also the effect of pro- 
ducing a sense of fulness in the head in the surgeon and 
assistants, which is rather objectionable." 

ANTHELMINTICS. 

The human body being infested with various parasites, 
whose presence is inconvenient and even dangerous, it is 
necessary for us to be provided with means for their safe and 
speedy removal. Some of these unwelcome guests are, un- 
fortunately, out of the range of medicine ; but others are so 
placed that they can readily be destroyed ; and we shall 
arrange them in classes, according to the several drugs which 
act especially upon them. 

1. Tape-worms are, 1. The best remedy for the 
the taenia solium, derived from taenia is now believed to be 



ANTHELMINTICS. 



61 



eating measly pork ; the taenia 
medio-canellata, from veal or 
beef; and the taenia lata, from 
salmon. These occupy the 
small intestine, and give rise 
to various ill-defined but un- 
comfortable sensations. 



2. The round-worm, or 
asearis lumbrieoides, 

inhabits the small intestine, 
and occasions a long array of 
nervous symptoms, more es- 
pecially in children. These 
worms are supposed to be in- 
troduced into the system by 
impure water. 

3. The thread - worm, 
or oxyuris vermicula- 
ris, resides in the caecum or 
colon, and causes much itch- 
ing and irritation around the 
anus. They are almost uni- 
versal among the children of 
the poor, but opinions differ 
as to whether they must be 
regarded as the cause or the 

6 



male-fern oil [oleo-resina as- 
pidii] given on an empty 
stomach ; but if this should 
possibly fail', we may have re- 
course to kousso, turpentine, 
pomegranate root [pelletier- 
ine], or areca nut. 

[Pumpkin seed (one or 
two ounces) made into emul- 
sion with milk is a good do- 
mestic remedy.] 

We must remember that, 
although these remedies kill 
the worms, they do not neces- 
sarily expel them from the in- 
testines, and that a purgative 
may be required for this pur- 
pose. It is also essential to 
find the head of the tape- 
worm before we can assure 
our patient that he is freed 
from his tormentor. 

2. Santonin acts as a true 
specific in at once destroying 
these troublesome parasites. 
[It is usually combined with 
calomel and soda to prevent 
the peculiar symptoms of 
santonin poisoning. Spige- 
lia and senna have a well- 
deserved reputation for ex- 
pelling these worms.] 

3. It would seem rather a 
roundabout practice to attack 
parasites in the lower gut by 
drugs administered through 
the mouth ; and although oc- 
casional purgatives, such as 
scammony, calomel, jalap, 
etc., are of use in these cases, 
our chief reliance must be 
placed on enemata of quassia, 



62 



ANTHELMINTICS. 



effect of the peculiarly ca- 
chectic condition with which 
their presence so often coin- 
cides. 

Other forms of parasitic 
intrusion within the various 
tissues are well known, but 
are generally incurable ; and 
the trichina spiralis, the vari- 
ous forms of hydatid disease, 
etc., must usually be permit- 
ted to run their destructive 
course unchecked. When, 
however, hydatids are placed 
in the liver, they are fre- 
quently effectually removed 
by tapping, whilst those in 
the lungs not uncommonly 
undergo spontaneous cure. 



tincture of iron, lime-water, 
common salt, etc. [and strict- 
ly regulating the diet.] 

In the general treatment 
of parasites, however, we must 
not trust entirely to the use 
of anthelmintics, but must 
also exclude all possibility of 
infection by forbidding raw 
or underdone meat, or fish, 
and by insuring general clean- 
liness and an uncontaminated 
water-supply. In addition to 
this, we must remedy the un- 
healthy condition of mucous 
membrane which favors their 
development, by giving alka- 
line remedies and bitter tonics 
in various forms of combina- 
tion. [Glycerine has proved 
effective in trichiniasis.] 



In prescribing our remedies for the expulsion of the tape- 
worm, it is well to secure a thorough evacuation of the intes- 
tines, so that the parasite may not be in any way shielded 
from the action of the drug by food or mucus. After a pre- 
liminary purge, we direct our patient to fast for a few hours, 
and then administer the fern-oil in milk, either at bedtime 
or in early morning. 



Parasiticides. 



The various external para- 
sites which infest the body 
may be divided into : — 

1. Animal, including the 
Guinea-worm, the acarus sca- 
biei causing the itch and the 
various pediculi met with 
on the head, pubis, and other 
hairy regions. [Fleas may 
infest the clothing.] 



1. The Guinea-worm is re- 
moved by gentle traction ; 
the itch insect destroyed by 
sulphur or staphisagria ; and 
the lice killed by mercurial 
applications [or insect pow- 
der and soap and water. 



ANTIDOTES. 



63 



2. Vegetable, to which pa- 
rasitic skin-diseases are due. 
Thus we have the micros- 
poron furfur of pityriasis ver- 
sicolor, the Ackorion Schbn- 
leinii of favus, the Trico- 
phyton tonsurans of .tinea 
tonsurans, and the various 
other forms met with in trop- 
ical practice. 



Body lice and fleas require 
disinfection or destruction of 
clothing as well.] 

2. The various parasitic 
diseases of the skin are of too 
well-known obstinacy, and 
may be treated in a variety 
of ways. Iodine, acetic acid, 
chrysarobin, mercurials, sul- 
phurous acid, carbolic acid, 
and a long array of drugs 
have each their enthusiastic 
partisans. 



ANTIDOTES. 



The first thing to be done 
in any case of poisoning is to 
empty the stomach, and to 
eliminate the poisonous sub- 
stance from the tissues. 



The next stage in our pro- 
ceedings must be to obviate 
the tendency to death, ac- 
cording to the various vital 



This may be effected in the 
first place by emetics, and 
more especially those of the 
direct class ; but, it will often 
happen, particularly in nar- 
cotic poisoning, that emetics 
will not act, and that we are 
forced to have recourse to the 
stomach-pump. Caution in 
the use of this instrument, 
however, is requisite in cases 
of irritant poisoning in which 
the mucous membrane of the 
stomach is softened or par- 
tially destroyed. When eva- 
cuation of the stomach has 
been completed, we may em- 
ploy gentle purgatives and 
diuretics in addition to such 
remedies as iodide of potas- 
sium which favor the elimi- 
nation of metallic substances. 

Thus, if cardiac syncope 
be the main symptom, we 
must give stimulants; if the 
respiratory centre seems in 



64 



ANTIDOTES. 



processes attacked by the 
poison. 



Having got so far, we must 
then proceed to use our anti- 
dotes proper, which may be 
divided into (1) Chemical, 
which directly neutralize the 
action of the poison by de- 
stroying its properties; and 
(2) Physiological, which have 
distinctly antagonistic prop- 
erties, being, indeed, in many 
cases, absolute counter-poi- 
sons. 



danger of becoming para- 
lyzed, we must excite respi- 
ratory action by cold affu- 
sion, irritation of the skin, 
and the employment of arti- 
ficial respiration, and give 
atropine which stimulates the 
origin of the pneumogastric 
nerve in the medulla ; if nar- 
cosis prevail, we must endea- 
vor to rouse the brain ; and 
if irritation of any particular 
organ arises, we must soothe 
it by appropriate remedies. 
[The aid of electricity will be 
found to be not only useful, 
but in some cases absolutely 
indispensable.] 

1. Among the first class 
we may rank alkalies in acid 
poisoning, animal charcoal 
[and tannic acid] as render- 
ing the vegetable alkaloids 
innocuous, and liquor potas- 
sae as depriving belladonna 
and its congeners of all 
physiological power. 

2. The second contains 
all those various substances 
which will be found described 
here and there in these pages 
as directly antagonistic to 
one another, as opium within 
certain limits to belladonna, 
Calabar bean to atropine and 
strychnine aconite to digita- 
lis. This class of antidotes 
has the advantage over the 
more purely local or chemi- 
cal, that they are able to pur- 
sue their foe into the blood, 
and attack it boldly and suc- 
cessfully there. 



ANTIPYRETICS AND REFRIGERANTS. 



65 



[Antidotes to special poisons are considered under their 
appropriate headings in the succeeding sections. At the 
close of the book will be found a condensed " List of Poi- 
sons and their Antidotes" for convenient reference and 
study.] 



ANTIPYRETICS AND REFRIGERANTS. 

Antipyretics. 



Antipyretics are remedies 
which reduce the bodily tem- 
perature, some acting only 
against the preternatural heat 
of febrile conditions, whilst 
others can also cool down the 
natural warmth below the 
normal standard. We may 
thus divide their action : — 



Class 1. Those which act 
by directly cooling the sur- 
face of the body by local ap- 
plication. 



Class 2. Those which act 
by internal administration, 
either lessening oxidation, or 
exerting some special influ- 
ence on the nervous system. 



In this country we are not 
much in the habit of regard- 
ing the temperature, per se, 
as a special element of dan- 
ger, unless it goes beyond a 
certain height, and we, there- 
fore, do not, as a rule, treat 
this symptom very energeti- 
cally. Foreign experience 
seems to show that, although 
we may reduce the actual heat 
in acute disease, we do not 
necessarily alter the course of 
the attack, and we, therefore, 
usually confine our efforts to 
supporting our patient and 
looking out for complications. 
On the other hand, however, 
when the thermometer regis- 
ters 105°, and still tends up- 
wards, we are bound to inter- 
fere. 

1. This is, undoubtedly, 
our most effectual antipyretic 
means, and may be carried 
out by cold affusion, wet pack, 
or, best of all, by the care- 
fully graduated cold bath. 

2. This class consists of 
the antipyretic drugs, prop- 
erly so called, such as qui- 
nine, digitalis, veratria, alco- 
hol, salicylic acid, etc. ; but, 



ANTIPYRETICS AND REFRIGERANTS. 



with the exception of the last- 
named, they are not much 
used for this purpose. It is 
a remarkable fact, that very 
few, if any, of these drugs 
have the power of reducing 
the normal temperature, save 
when given in large and al- 
most poisonous doses (vide 
Alcohol, Quinine, etc.). 

3. Under this heading we 
must include the whole class 
of diaphoretics, as well as 
chloral hydrate, the warm 
and Turkish bath, etc. [Car- 
diac depressors like aconite, 
arnica, and veratrum viride 
have also the effect of dilat- 
ing the arterioles and re- 
ducing blood pressure and 
temperature in this way.] 



Class 3. Those which act 
by dilating the superficial 
vessels and enabling a larger 
sheet of blood to be spread 
over the cutaneous surface, 
and thus brought in contact 
with the cooling influence of 
the air. The chilling effect 
then produced by the return 
of the circulating fluid to the 
heated centres, although very 
transient, may become con- 
siderable by repetition. 

Class 4. Remedies which 
act by bracing up and 
strengthening the nervous 
system, and removing some 
of that enfeebled and semi- 
paralyzed condition on which 
febrile temperatures have 
been supposed to depend. 

Liebermeister and those who agree with him adopt the 
antipyretic plan in its entirety and combine these various 
agents. Whilst using very frequent baths, as often as every 
two hours — in severe cases two hundred, even, having been 
given during one illness — he orders quinine in large doses, 
holding it first among cooling agents ; digitalis where the 
heart is strong, thus reversing our usual therapeutical rules ; 
and veratrine, which seems to act by causing a kind of col- 
lapse. Statistics, however, do not show any superiority of 
this over the more expectant plan practised in England. 
Prof. Gairdner {Glasgow Med. Jovrnal, September, 1878) 



4. A rising temperature 
being often an indication of 
debility, we may then check 
it by tonics, good food, small 
doses of alcohol, etc. 



ASTRINGENTS AND CAUSTICS. 67 

well calls the German plan a battledore and shuttlecock 
treatment, consisting, as it does, " in keeping the patient, 
partly by means of cold baths, and partly by these other 
remedies, in a state of constant oscillation between fever 
and incipient collapse." 

Refrigerants. 

Refrigerants, of course, necessarily include all remedies 
which actually lower the bodily temperature, but the con- 
ventionally accepted meaning of the term merely implies 
anything which alleviates thirst. Thus we find that the 
mere sipping of any fluid moistens the dry tongue and 
lessens the thirst of fever, whilst acids, by stimulating the 
secretion of saliva, may fulfil the same indication in a more 
scientific and effectual way. 



DISINFECTANTS AND ANTISEPTICS. 

Disinfectants are " agents capable of so modifying the con- 
tagium of a communicable disease, during its transit from a 
sick to a healthy individual, as to deprive it of its specific 
power of infecting the latter." (Baxter.) 

Antiseptics have the power of arresting the activity of 
septic germs, or of destroying their vitality. The principal 
antiseptics are carbolic acid, creasote, zinc chloride (thymol, 
boric acid, salicylic acid), sulphurous acid, corrosive sub- 
limate, and sodium chloride. 



[ASTRINGENTS AND CAUSTICS. 

The property of astringency, or " puckering," is possessed 
by vegetable substances containing tannic acid and its deri- 
vatives ; and, on the other hand, by many mineral salts. 
Astringents generally possess the power of coagulating albu- 
men, but their therapeutic effect is rarely required to this 
extent ; in less degree of strength they excite a tendency to 
condensation or contraction of living organisms, partly, but 
not mainly, by local influence upon the unstriped muscular 
fibres. In a higher degree they generally act as irritants, or 
even caustics. When used to check bleeding they are 
termed styptics. Astringents find their greatest field of 
usefulness in a relaxed condition of mucous surfaces with 



68 COUNTER-IRRITANTS. 

excessive follicular secretion. In cases of inflammation 
their tendency to exercise an irritant influence should not 
be lost sight of. 

Extremes of temperature such as are obtained by either 
hot or cold applications will check hemorrhage ; the cold 
acts as an astringent, but the heat more rapidly coagulates 
blood. 

The vegetable astringents are tannic and gallic acids, and 
their allied forms, as kino-tannic and catechu-tannic and 
gallo-tannic. Acetic acid and weak solutions of carbolic 
acid also are decidedly astringent. It may be that the effect 
of chrysophanic acid in psoriasis is largely due to an astrin- 
gent effect upon the vascular supply of the diseased skin. 

The principal mineral astringents are sulphuric acid, and 
the soluble sulphates generally, particularly the ferrous and 
cupric sulphates; but the soluble compounds of zinc, silver, 
lead, copper, cadmium, and aluminium are generally astrin- 
gent. The ferric salts with mineral acids, the ammonio- 
ferric sulphate, the calcic hydrate and carbonate, alum, sub- 
nitrate and subcarbonate of bismuth, and some of the volatile 
oils and resins are also to be included in this category. 

Caustics are used to destroy tissues, and belong more par- 
ticularly to surgery. When the application is mitigated or 
used in dilute solutions, the first effect of caustics, as a rule, 
is that of a stimulant and irritant, and they may exert an 
astringent effect. The principal agents used as caustics may 
be classified according to their action as follows : — 

CAUSTICS. 

PENETRATING. CIRCUMSCRIBED. 

Acetic acid. Dried alum. 

Bromine. Dried zinc sulphate. 

Chromic acid. Heat. 

Mercuric nitrate solution. Potassa with lime. 

Potassa. Silver nitrate. 

Sulphuric type-acids. Zinc chloride.'] 



COUNTER-IRRITANTS. 

The theory of the action of epispastics and rubefacients 
has given rise to much interesting physiological speculation, 
but we are not yet able to lay down, with absolute precision, 



COUNTER-IRRITANTS. 69 

the laws on which the beneficial action of these remedial 
agents depends. We know this much, however, that blis- 
ters may occasionally act locally on deeper-seated parts, as 
we are told that redness and inflammation of the pleura and 
peritoneum may be produced by the vesicating influence of 
cantharides applied to the cutaneous surface superficial to 
these structures. 

Then, again, vascular connection may explain other phe- 
nomena, and more especially may this be traced in the chest 
between the pericardial vessels and those of the skin imme- 
diately over the heart, and in the lumbar region between the 
superficial vascular supply and that which furnishes to the 
kidneys their due allowance of arterial blood. 

These more direct and obvious explanations of various 
interesting therapeutical phenomena do not, however, lead 
us very far, and we are compelled to fall back upon much 
more abstruse considerations. Into these neither our space 
nor the scope of the present volume will permit us to enter 
very far, and we only very briefly draw a slight outline of 
those branches of the question which seem to have reached 
something of vigorous growth. 

Now for the relief of pain, counter-irritation may act, 1st, 
by removing or modifying the structural condition on which 
the reflected suffering depends, as we often cure a facial 
neuralgia by extracting a carious tooth ; or 2d, the end organs 
of the sensory nerves may be modified in molecular arrange- 
ment; or 3d, the trunks of the nerves themselves, or the 
nuclei or the nervous centres, may be altered in some unex- 
plained way by the stimulus applied to the seat of pain. 

For other purposes, also, counter-irritation may act by 
altering or re-distributing blood supply, as by actually empty- 
ing the deeper vessels and filling the more superficial arteri- 
oles at their expense ; or special function or nutrition may 
be profoundly affected by influencing the trophic or other 
nerves which more especially preside over these departments 
of the economy. 

The practical applications of counter-irritation in the 
treatment of disease are both numerous and interesting, and 
when considering iodine, mustard, and cantharides, we will 
devote some space to the consideration of the principles 
which should guide us to their successful use. 



70 



DIAPHORETICS AND ANHIDROTICS. 



DIAPHORETICS AND ANHIDROTICS. 



This class of remedies has 
the property of increasing 
the secretions of the skin, 
and is usually divided into 
(1) the stimulating and (2) 
the sedative. Under the 
first heading we include 
those drugs which stimulate 
the cutaneous circulation, 
among the principal of which 
are ammonia, alcohol, the 
cold bath, phosphorus, etc. ; 
and, secondly, we speak of 
the sedative class, which act 
by dilating the superficial 
vessels, these being ipecac- 
uanha, tartar emetic, jabo- 
randi, aconite, the warm 
and hot air bath, and all the 
nauseating and emetic sub- 
stances, the depressing ac- 
tion of which is invariably 
attended by free perspiration. 
Then again we must refer to 
what are known as adjuvant 
remedies, such as warmtli to 
the surface, diluent drinks, 
etc. 



Diaphoretics are used 
freely in practice at the out- 
set of acute diseases, to relax 
the contracted vessels and 
relieve the hot, dry skin ; and 
in pneumonia this line of 
treatment has produced good 
results. The sedative class 
would seem to be best adapted 
for this purpose ; but the 
cold bath, which more natu- 
rally belongs to No. 1, has 
been freely used abroad in 
febrile disorders, and part of 
its beneficial effects must no 
doubt be due to its action on 
the skin. 

In eruptive fevers, when 
the eruption is not sufficiently 
developed, we endeavor to 
excite the function of the 
skin, and thus favor the local 
manifestation of the poison, 
by warm baths, wet-packing, 
and possibly by phosphorus. 
We also use diaphoretics to 
favor absorption, as in various 
dropsies, and to relieve the 
kidneys, between which and 
the skin so much sympathy 
exists. 

They are also of service 
by assisting to eliminate mor- 
bid products from the blood. 
When the various internal 
organs, whose duty it is to 
get rid of certain effete and 
hurtful matters, are tempo- 
rarily or permanently off 
work, we may hope to sup- 



DIURETICS. 



u 



ply their place in some meas- 
ure by the skin, and in 
Bright's disease we may thus 
relieve the system of* some 
urea ; in jaundice, of biliary 
products, etc. 



DIURETICS. 

Diuretics stimulate and increase the flow of watery fluid 
through the kidneys in various ways, which we may conve- 
niently classify under the following headings : — 

Class 1. Stimulating diu- 1. These are cantharides, 
retics, which act by directly turpentine, colchicum, squill, 
exciting or irritating the nitrate of potassium, etc., 
glandular secreting structures but they are rarely thus used, 
of the kidney. as they are liable to produce 

pain, strangury, and even 
hemorrhage. Cantharides 
has, however, been recom- 
mended in some forms of 
chronic albuminuria and in 
pyelitis. 

2. The principal of these 
are digitalis, belladonna, 
squill and ergot; and they 
are of service in various drop- 
sies, and perhaps most espe- 
cially in those which depend 
on disease of the heart. 



Class 2. Those drugs which 
stimulate the circulation, 
called by Gubler vaso-motor 
diuretics, causing increased 
arterial tension, and thus 
greater pressure on the walls 
of the Malpighian bodies, by 
which means transudation of 
watery fluid is mechanically 
favored. 

Class 3. "We next come to 
the saline diuretics, which, 
in addition to some slightly 
stimulating influence, have a 
special power of absorbing 
and holding watery fluids, 
which they then carry with 
them in their exit from the 
body. 



3. In this group we include 
the lithium, potassium, and 
sodium salts, and most of 
them possess a double action, 
being diuretic in small, and 
purgative in large doses. 
They are also used with ad- 
vantage in anasarca and drop- 
sical accumulations. 



72 



DIURETICS. 



Class 4. Mechanical diu- 
retics must next be included 
in the list, and among the 
principal of these we may 
mention water, which acts 
by washing the urinary tu- 
bules clear from epithelium 
or casts, which block them 
under certain conditions, and 
so allowing secretion to be 
re-established. Under this 
heading we may also group 
those remedial means which 
act indirectly by relieving 
the kidneys in various ways. 
Thus, when congestion is 
present, . local bleeding, dry 
cupping, warm fomentation, 
etc., may be the best diure- 
tics. When the kidneys are 
pressed upon by ascitic fluid, 
a renewal of their full func- 
tion frequently follows the 
operation of tapping, and in 
many cases we may give 
these organs temporary rest 
by handing some part of 
their duties over to the skin 
or the bowels. 

Diuretics are notoriously uncertain remedies, and many 
of them have not the slightest power of increasing the flow 
of urinary water during health. They also vary much in 
their power of promoting the elimination of urea and other 
products of excretion by the kidneys. They may be given 
either by the mouth or by vapor (in which way oil of juniper 
acts well) ; or, as in the case of digitalis, they may be effi- 
ciently used by cutaneous absorption. In their administra- 
tion we must observe the following rules : Give them freely 
diluted, and, as a rule, combined with one another, several 
remedies of the class seeming to act better than one, as in 
the famous Guy's pill. Keep the patient cool, so as to avoid 
any action on the skin, and endeavor to prevent the bowels 
from coming too freely into play. 



4. Dr. Dickinson has shown 
how well copious draughts of 
water act in the acute de- 
squamative nephritis of chil- 
dren, on the mere mechanical 
principle of sluicing or wash- 
ing out the obstructed tu- 
bules. The indirect diuretics 
are often of most service in 
renal disease; and Christison, 
Gairdner, and other experi- 
enced authorities have always 
upheld the benefits to be de- 
rived by the treatment of 
Bright's disease in all its 
stages by the less stimulating 
forms of diuretics. A good 
way of promoting the ab- 
sorption of fluid effusions and 
of largely increasing the uri- 
nary flow, is by placing the 
patient on a very dry diet 
and cutting off, as far as pos- 
sible, the supplies of fluid. 



EMETICS. 73 



EMETICS. 



The object of an emetic is to stimulate the so-called 
vomiting centre in the medulla oblongata, close to the origin 
of the pneumogastric nerve, and induce it to call forth -the 
complicated series of muscular acts which terminates in 
evacuation of the stomach. Emetics act in two ways, and 
are thus classed, as: — 

1. Direct. — Where the drug irritates the filaments of the 
pneumogastric nerve distributed to the mucous membrane of 
the stomach, and this irritation, being transmitted to the 
centre, is reflected in motor impulses through the pneumo- 
gastric, phrenic, and intercostal nerves. The direct emetics 
are prompt in their action, and cause little nausea and depres- 
sion ; and the principal members are zinc sulphate, copper 
sulphate, ammonium carbonate, mustard, common salt, etc. 

2. Indirect. — Emetics of this class are conveyed directly 
by the medium of the blood to the vomiting centre, and act 
well by injection without coming into contact with the stom- 
ach. They are less prompt and more depressing than those of 
the other class. Principal members : Ipecacuanha (emetia), 
tartarized antimony, apomorphina, veratrina, and del- 
phinina. 

The reflex chain then being established by which the 
muscular apparatus causes vomiting, we must next consider 
the various steps of the process. 

Physiology of Vomiting. Therapeutics. 

1. In the first place the Emetics are used to empty 
cardiac sphincter of the stom- the stomach in cases of poison- 
ach must be relaxed, or no ing, and here we invariably 
vomiting can take place, and employ the direct class, such 
the persistent contraction of as the zinc sulphate, mustard, 
this structure may account salt, # etc. If the patient be 
for many cases of distressing unable to swallow, we may 
retching. attain one object by the sub- 

2. The actual contraction cutaneous injection of apo- 
of the walls of the stomach morphine. 

itself must be supplemented They are also of service in 
by that of the abdominal some forms of dyspepsia, and 
parietes. to clear the stomach in in- 



74 



EMETICS. 



3. The diaphragm descends 
and becomes fixed. 

4. The glottis is closed so 
that the various muscles com- 
pressing the stomach act be- 
tween two fixed points. 

5. As vomiting cannot be 
effectually accomplished if 
the stomach is quite empty, 
under these circumstances 
the patient generally swal- 
lows a certain quantity of air, 
so as to distend the viscus. 



toxication, and for the relief 
of the convulsions of infancy, 
which often depend on irri- 
tating articles of diet. 

The regular use of the 
stomach-pump at stated in- 
tervals has proved useful in 
cases of dilated stomach with 
sarcinous vomitingand serious 
digestive derangement. 



1. Action on the Brain 

and Nervous System 

Emetics may cause some 
congestion of the brain by 
the obstructed venous return 
from the neck during the act 
of vomiting. 

2. Circulation and Respi- 
ration They have a seda- 
tive action on the heart. 

As the respiratory is close 
to the vomiting centre, the 
breathing generally becomes 
sighing and irregular during 
the act of vomiting ; but in 
addition to this there is an 
increase of secretion from the 
pulmonary mucous mem- 
brane, and the compression 
of the lungs forces retained 
mucus out of the bronchial 
tubes. 

3. Organs of Secretion. — 
By the pressure exerted on 
the intestines, some slight 
purgative action may result, 
and prolonged vomiting al- 
ways leads to the discharge 
of bile from the stomach by 



1. We must therefore avoid 
their use in apoplectic cases. 



2. Emetics are of great 
service in clearing the lungs 
in bronchitis, and in getting 
rid of the false membrane 
in croup and diphtheria, and 
they may thus be said to act 
as expectorants. We had 
here best use such emetics as 
ipecacuanha and tartarized 
antimony, which combine an 
expectorant action. 



3. Emetics may therefore 
be said to act as cholagogues, 
and may be of great service 
in stimulating the action of 
the liver, and removing in- 
spissated secretions from the 
gall-bladder. Some authori- 



EMMENAGOGUES AND ECBOLICS. 



75 



the mechanical squeezing of 
the liver and gall-bladder. 
Cutaneous emetics invariably 
cause free perspiration during 
their action, as well as an in- 
creased flow of saliva. 



ties hold that it is good prac- 
tice to give an emetic as 
early as possible at the outset 
of fevers, such as enteric ; 
and it has been suggested 
that the fever poison is re- 
tained at this stage in the 
bile, and may be expelled 
along with it from the system. 



EMMENAGOGUES AND ECBOLICS. 

Of these we may consider, first, 



Ecbolics. 



Physiological Action. 

Ecbolics are substances 
which cause such violent 
contraction of the pregnant 
uterus as to effect the expul- 
sion of its contents. It is 
not quite certain whether 
the principal members of the 
group act specially on the 
muscular structures of the 
organ, or whether a primary 
intervention of nervous in- 
fluence through the spinal 
cord is necessary. 



Therapeutical Action. 

Ecbolics are used exten- 
sively in obstetric practice 
when it becomes necessary to 
stimulate the flagging powers 
of an exhausted uterus — the 
principal being ergot, digi- 
talis, savin, borax, quinine. 
We are also compelled, under 
certain circumstances, to have 
recourse to the induction of 
premature labor, as when 
dangerous sickness goes on 
unchecked, or when weak- 
ened abdominal or thoracic 
viscera are injuriously com- 
pressed by the pregnant ute- 
rus. In such cases, however, 
it is generally found best to 
use mechanical means. 



EMMENAGOGUES. 

May be direct or indirect. 
Physiological Action. Therapeutical Action. 

Direct emmenagogues act Most of the ecbolic drugs 

merely by restoring the nor- act as emmenagogues when 



76 



EXPECTORANTS. 



mal functions of the uterus 
when these are suspended. 



Indirect emmenagogues act 
by removing some constitu- 
tional condition which inter- 
feres with the due perform- 
ance of the uterine functions. 
Thus amenorrhoea very fre- 
quently depends on anaemia, 
or constipation may require 
removal before our more spe- 
cial remedies will act, or 
there may be constriction of 
the os or atony of the uterus, 
or the spine may be at fault. 



given in small doses to a non- 
pregnant patient, and to the 
list we may add rue and can- 
tharis. Of all these, however, 
ergot is by far the most ef- 
fectual. 

The different preparations 
of iron, in combination with 
aloetic or other purgatives, 
act well, and we may aid our 
chances of success by all hy- 
gienic means, as well as by 
warm hip-baths, leeches, 
placed preferably on the in- 
ternal condyles of the femurs, 
and mustard stupes, at the 
normal menstrual periods. 



EXPECTORANTS. 



These are remedies which facilitate in various ways the 
expulsion of secretions from the bronchial tubes. They may 
thus be divided : — 



1. The emetic class which 
are the most efficient of all, 
removing and softening the 
mucus, causing the transuda- 
tion of watery fluids, and re- 
laxing the muscular walls of 
the bronchial tubes. 



2. Nauseants may also be 
of service as expectorants. 



3. We then have what are 
called the stimulating expec- 



1. There can be no doubt 
that, when the lungs are 
choked with secretion, a good 
emetic often acts like a charm, 
as in bronchitis, whooping- 
cough, etc. 

We here use to best ad- 
vantage the indirect emetic 
agents, as ammonium car- 
bonas, ipecacuanha, etc. 

2. These are merely the 
indirect emetic drugs given 
in small doses, as antimony, 
ipecacuanha, etc. 

3. These are senega, ammo- 
nium carb., etc. ; but it is evi- 



NARCOTICS AND ANODYNES. 



77 



torants, acting either on the 
general vascular system, or 
specially on the nervous and 
muscular structures of the 
lungs. 



4. Those remedies which 
promote secretion from a dry 
and swollen mucous mem- 
brane. 



5. Expectoration is often 
rendered difficult by tena- 
city of the mucus, which is 
coughed up, only after much 
straining and effort, and great 
relief follows every drug which 
can thin or liquefy the secre- 
tion. 

6. Spasmodic contraction 
of the smaller bronchial tubes 
may interfere with free ex- 
pectoration. 



dent that any tonic or stimu- 
lating remedy may frequently 
act indirectly as an expector- 
ant, by improving the tone of 
the circulation, and giving the 
patient strength to cough and 
clear his lungs. The stimu- 
lating expectorants are more 
especially used in the later 
stages of pulmonary disease. 

4. In the earlier stages of 
bronchitis much discomfort 
occurs from the dry hard 
cough and difficulty of breath- 
ing arising from swelling of 
the bronchial mucous lining. 
Great relief is experienced 
when free expectoration is 
established, and this may be 
promoted by inhalation of 
steam and the administra- 
tion of liq. ammonii acet., 
lobelia, and the class of nau- 
seants generally. 

5. We find that alkalies act 
well here, and, if any gouty 
tendency exists, potassium 
iodide more especially. 



6. Here we may hope to 
obtain relief by the use of 
opium, belladonna, stramoni-. 
lira, tobacco, etc. 



NARCOTICS AND ANODYNES. 

Narcotics, as the name implies, are those remedies which 
cause sleep, and they do so by imitating the normal physio- 
logical arrangement of that condition, and producing an anre- 

7* 



78 



NARCOTICS AND ANODYNES. 



mic state of the cerebral hemispheres. Why they act in this 
selective way on the brain is not very clear ; for although 
opium contracts the bloodvessels, thus arresting nearly all 
secretion, chloral has a dilating effect, and pot. bromid. has 
not been proved to have any special action on the circulation 
at all. Bernard's theory of independent vascular areas acted 
on by special drugs, only removes the difficulty further back, 
as, of course, we are totally unable to explain why one drug 
affects one region or function, and a different one another. 
But whatever the explanation may be, we all gratefully ac- 
knowledge the enormous benefits derived from the control 
over the reparative process of sleep which these remedies 
afford us, and a reasonable mode of division seems to be into 
— 1st, direct narcotics ; 2d, indirect narcotics. As a general 
rule we must exhaust all the resources of class 2 before we 
have recourse to class 1, remembering the fascination which 
these drugs exert and the pitiable condition of slavery to 
which they reduce their victims. 

1. Direct Narcotics. 



Physiological. 

These are the following 
drugs, named in their order 
of potency, as opium, chloral 
hydrate, paraldehyde chloro- 
form, potassium bromide, hy- 
oscyamus, belladonna, hop, 
and Indian hemp. The pe- 
culiar action of chloral, how- 
ever, occasionally causes its 
failure in cases of debility, 
where it acts by increasing 
the natural tendency of the 
relaxed arteries to dilate, thus 
flushing the brain with blood 
during recumbency, effectu- 
ally preventing sleep. 

We must also remember 
the depressing effect of chlo- 
ral on the heart's action. In 
prescribing narcotics we must 



Therapeutical. 

Opium is, beyond doubt, 
the most potent and certain, 
and, perhaps, least dangerous 
narcotic ; but the digestive 
disturbance unhappily follow- 
ing its use often interferes 
with its continued adminis- 
tration. It is, no doubt, best 
adapted of all the remedies of 
this class for use in fevers and 
in all painful conditions, on 
account of its anodyne pro- 
perties. Chloral is more to 
be recommended in simple 
insomnia, in delirium tre- 
mens, and in all cases where 
we wish to keep up a pro- 
longed narcotic effect, as it is 
not requisite, as a general 
rule, to increase the dose. 



NARCOTICS AND ANODYNES. 



79 



very carefully study the in- 
dividual peculiarities of our 
patients, and prescribe our 
first dose of any member of 
the group with caution. Some 
people bear opium badly, and 
are furiously excited by doses 
which usually prove narcotic. 
Chloral sometimes causes 
faintness and nausea, bromide 
of potassium now and then 
fails of its effect, so that we 
require to feel our way with 
scientific timidity. 



Bromide of potassium is well 
adapted to soothe the system, 
when once excited by worry 
or over-work, and the others 
are occasionally useful when 
success has not been attained 
by other means. 



2. Indirect Narcotics. 



Physiological. 

First on this list we must 
place those drugs which sec- 
ondarily affect the brain cir- 
culation by toning up the ar- 
teries, and thus regulating the 
supply of blood. Digitalis is 
here all important; and iron, 
also, has its place, by improv- 
ing the quality of the blood. 
A little alcohol, given at the 
right time, will often produce 
sleep; and it is well known 
that the state of exhaustion 
produced by an empty sto- 
mach will often lead to pro- 
longed wakefulness, only to 
be removed by a little food. 
Tea and coffee taken late at 
night often prevent sleep. 

Darkness and quiet, and 
warmth, promote slumber, 
and the opposite condition 
of cold is well known to 
cause a comatose condition, 
too often ending in death. 
Sleep, again, is promoted by 



Therapeutical. 

Digitalis often acts very 
efficiently, as a narcotic, by 
removing that relaxed condi- 
tion of vessels which substi- 
tutes congestion for anaemia, 
when the patient lies down ; 
a little alcohol at bed-time, 
more especially for the aged, 
is an excellent " night cap." 
When we find weakly per- 
sons complaining of want of 
sleep, we will do well to or- 
der a cup of milk or a little 
beef- tea, or other simple 
nourishment, to be taken at 
bed-time, or placed by the 
bed-side for use in the early 
morning hours, when the 
power of life begins to flag. 

Suitable bed-room arrange- 
ments are very important, as 
some persons are at once 
awakened by the faintest ray 
of light. Some like a hard 
bed, others, a soft ; according 
to their personal habits, and 



80 



NARCOTICS AND ANODYNES. 



the removal of everything 
which excites the patient. 



Thus, hyoscyamusor conia, 
or atropine, by stilling the wild 
ravings of mania, may be 
truly narcotic, and remedies 
of the next class are often ef- 
fective members of the major 
group, by lulling or removing 
pain, which made sleep im- 
possible. 

Anodynes. 



we must carefully regulate 
the blanket coverings ac- 
cording to the season of the 
year. Cold feet often cause 
insomnia, and a hot- water 
bath will be found of service 
in winter ; whilst an open 
window seems essential in 
some cases before sleep can 
be obtained. 

Wakefulness may be the 
result of too low a pillow, 
the head being on the same 
plane as the body, and the 
blood encouraged by the flac- 
cid vessels to flush the brain, 
and some persons have a su- 
perstitious feeling, which .is 
probably worthy of encour- 
agement, that the bed should 
invariably be placed north 
and south. 

In some cases of sleepless- 
ness cold to the head com- 
bined with a hot foot-bath 
has proved successful. 

These drugs have done 
good service in asylum prac- 
tice. 



Physiological. 

Anodynes act by lulling 
pain, probably by interfering 
with the conducting power of 
sensory nerves. Opium pos- 
sesses this power, which is 



Therapeutical. 

Of all anodynes opium is 
the best, and more especially 
morphine by subcutaneous 
injection, which rarely fails 
to lessen, and often speedily 



PURGATIVES. 



81 



absent in chloral, and then 
■we have aconite, belladonna, 
chloroform, compound spirits 
of aether, etc., which may 
soothe locally, as well as con- 
stitutionally. 



removes pain ; chloral only 
removes pain during sleep, 
but curare is probably a true 
[muscular] sedative. Local 
application of anodynes is 
only serviceable in acute in- 
flammation, neuralgia, rheu- 
matism. 



PURGATIVES. 



Purgatives may be divided, first, into two classes depend- 
ing on their origin, and these are : — 

1. The inorganic substances, comprising chiefly the mer- 
curials and salines. 

2. Those derived from the vegetable kingdom, and which 
depend for their therapeutical action on the presence of resins 
or oils. 

Their actual modes of operation, however, are much more 
varied, and they will best be considered by division under 
various headings, according to their physiological and thera- 
peutical properties. 

1. The principal of these 
are sulphur, castor-oil, mag- 
nesia, etc. ; but in addition 
to actual drugs we may in- 
clude various articles of diet, 
as oatmeal, brown bread, 
whole flour, figs, prunes, etc., 
which act purely mechani- 
cally. 

Laxatives are useful when- 
ever we desire a mild and un- 
irritating effect, as in simple 
constipation from dyspepsia, 
pregnancy, or convalescence 
from acute diseases, seden- 
tary habit, and other causes. 

Castor-oil acts well in the 
early stages of diarrhoea, by 
sweeping away the irritating 
cause. 



1. Laxatives These sub- 
stances act by causing a slight 
increase in the peristaltic 
movement of the intestines, 
with softening of the feces, 
which are then expelled in a 
solid and formed condition. 



82 



PURGATIVES. 



2. Purgatives produce 
more decided effects both in 
stimulating movement and 
secretion ; but it is difficult to 
separate them entirely from 
either class No. 1 or No. 3. 



3. Drastic Purgatives 

These run by insensible gra- 
dations into the preceding 
class. Their action depends 
on an irritation of the mu- 
cous membrane of the intes- 
tines, and not only an actual 
increase of secretion from 
their glands, but the with- 
drawal of watery fluids from 
the blood. An overdose, 
therefore, may be attended 
by serious depression, discom- 
fort, and even by death from 
inflammation of the bowels. 

4. Hydragogue purgatives 
cause very free secretion from 
the mucous membrane of the 
bowels, and empty the veins 
by withdrawing fluids from 
the blood. 



5. Saline Purgatives. — 
We shall, when treating of 
magnesium sulphate (Epsom 
salt), consider the action of 
this class, and point out 
how, from their low, diffusive 
power, they pass with diffi- 
culty into the blood, and how, 
whilst in the intestine, they 
not only absorb, retain, and 
carry away the watery fluids 
which they find in the intes- 



2. Rhubarb, senna, aloes, 
and jalap are reckoned among 
the chief of these, and they 
are used in various dyspeptic 
conditions, rhubarb being 
more especially stomachic, 
and aloes emmenagogue, in 
its properties. 

3. In this class we include 
jalap, scammony, colocynth, 
gamboge, and croton oil, and 
they are principally used 
either in obstinate constipa- 
tion, or to produce a deriva- 
tive or species of counter- 
irritant effects in various 
forms of brain disease. 



4. These are elaterium, 
cream of tartar, etc., and they 
are most useful in ascites and 
other dropsical conditions, 
and for the relief of a feeble 
and laboring heart by dimin- 
ishing the actual volume of 
the blood. 

5. Sulphate of magnesia 
and many of the salts of pot- 
ash and soda must here be in- 
cluded. They are best given 
in a state of free dilution, and 
make very efficient habitual 
purgatives, more especially 
in the form of various natural 
purgative waters, such as 
Friedrichshall, Pullna [and 
Congress water]. 



PURGATIVES. 



83 



tine, but also directly with- 
draw fresh supplies from the 
blood itself. Professor Mat- 
thew Hay, of Aberdeen, thus 
sums up an elaborate investi- 
gation lately made by him 
with the action of saline ca 
thartics: "They cause no 
irritation or inflammation of 
the intestinal canal, nor stim- 
ulate in the smallest degree 
the secretion of the more im- 
portant digestive juices, as the 
gastric, the pancreatic, and 
the biliary; have under or- 
dinary circumstances little 
action on the blood, and 
mainly act by increasing the 
intestinal secretion and hin- 
dering the absorption of the 
intestinal fluid." 

6. Cholagogue Purgatives. 
— Much experiment has re- 
cently been expended on the 
action of this class, and those 
recently conducted on im- 
proved principles by Prof. 
Rutherford have given us 
very precise and reliable in- 
dications for practice. Cho- 
lagogues have been held to 
act either by directly stimu- 
lating the secretion of bile, 
or by increasing the efficiency 
of the bile-expelling mechan- 
ism ; and as the elaborate 
important experiments of 
Rutherford have only refer- 
ence to the first action, he 
prefers to use the term hepa- 
tic stimulant. Although any 
explanation of the action of 
this class of remedies must 



6. The principal members 
of this group are podophyllin, 
rhubarb, aloes, jalap, mer- 
curic chloride [ammonium 
chloride], colchicum, euony- 
min, sanguinarin, ipecacu- 
anha, colocynth, sodium sul- 
phate, sodium benzoate, 
sodium salicylate. They are 
used for the relief of various 
functional affections of the 
liver, to remove what is com- 
monly known as " bilious- 
ness," and to obviate portal 
congestion. 



84 



PURGATIVES. 



be almost purely conjectural, 
Rutherford believes that the 
effect is due to " a direct ac- 
tion of their molecules upon 
the hepatic cells or their 
nerves." 

It is interesting to observe, 
as noted by Rutherford : a. 
" That when a substance 
produces purgation, but does 
not stimulate the liver, it di- 
minishes the secretion of 
bile. b. That when a sub- 
stance stimulates the liver as 
well as the intestinal glands, 
a moderate dose increases 
both the hepatic and the in- 
testinal secretions, the effect 
on the former being more 
marked in the earlier part of 
the experiment, and dimin- 
ishing as the purgative effect 



dose, by producing a violent 
purgative effect early in the 
experiment, may occasion 
nothing but diminished se- 
cretion of bile." 

7. Purgative Adjuvants. 
In addition to drugs belong- 
ing to the actual purgative 
class, we have many indi- 
rect remedies which act 
with considerable efficiency. 
Thus we may use enemata, 
cold to the abdomen, me- 
chanical kneading of the pa- 
rietes, or electricity, in order 
to stimulate the muscular 
tissues to contraction ; or we 
may cause a purgative action 
by relieving spasm. 



7. Among the stimulating 
class we may mention strych- 
nine, nux vomica, ergot, and 
the ferrous sulphate, and these 
are very efficient, in combi- 
nation with mild purgatives, 
where constipation depends 
on a lax or weakened state 
of the intestinal walls. 

When spasm or irregular 
contraction prevents free ac- 
tion of the bowels, we must 
have recourse to opium, bel- 
ladonna, or the lead acetate, 



STIMULANTS AND SEDATIVES. 



85 



which, under these conditions, 
may be looked upon as true 
cathartics. 

In administering purgatives, we must consider the various 
parts of the intestinal canal on which they act. Thus senna, 
jalap, etc., act on the small intestine, aloes on the large, 
podophyllin on the duodenum, etc. We must also consider 
the time of their administration, as we find that the slowly 
acting resinoid substances are best given at night or before 
dinner, whereas the salines are best taken on an empty 
stomach, and more especially before breakfast. The mode 
of administration is also worthy of note, the resinoids being 
best taken in the form of pill, whereas the salines act best 
in solution with free dilution and in combination with bit- 
ters, iron, or sulphuric acid. [In case it is desired to pro- 
tect the stomach from the action of the drug, it may be given 
during digestion in gelatine capsule or in pills coated with 
keratin.] 



STIMULANTS AND SEDATIVES. 

Stimulants and sedatives are so directly antagonistic in 
nature that the most satisfactory scheme of their action will 
be presented by direct contrast in parallel columns, accord- 
ing to the plan adopted generally throughout these pages. 



I. General Stimulants. 

As the principal members 
of this group we may mention 
alcohol, opium, and the an- 
aesthetic vapors, which, whilst 
stimulant in small, are nar- 
cotic in large doses ; the 
ethers and ammonia, which 
are called diffusible because 
rapid elimination prevents 
any marked display of their 
stupefying qualities. We 
may refer to the article on 
Alcohol for directions as to 
the use of stimulants in 



I. General Sedatives. 

The stimulating drugs in 
the opposite column, when 
carried beyond a certain 
point, cause a sedative or 
soothing action, and run by 
insensible degrees into the 
truly narcotic class of reme- 
dies. Over-stimulation pro- 
duces exhaustion and indi- 
rectly a sedative action. 

[Galvanism may be ap- 
plied so as to produce a se- 
dative effect upon sensory 
nerves, and thus relieve pain.] 



86 



STIMULANTS AND SEDATIVES. 



health and disease. Then 
again, the cold douche, coun- 
ter-irritation, and electricity 
may act as powerful stimu- 
lating agents under certain 
conditions. [In narcotic 
poisoning, faradic or static 
electricity is of great value 
in maintaining the action of 
the heart and muscles of 
respiration.] 



II. Special Stimulants. 

1. To the Nervous System. 
Alcohol, ether, and opium un- 
doubtedly stimulate the brain 
[by flushing it with blood, 
thus indirectly] causing 
greater intellectual activity 
and an increased flow of ideas, 
occasionally somewhat irregu- 
lar in form. Phosphorus 
may be ranked under this 
heading, and digitalis may 
improve the functions of the 
cerebral hemispheres by the 
more regular supply of blood 
which its tonic influence on 
the arterial system provides. 

The spinal cord is directly 
and powerfully stimulated by 
strychnine, and in the lower 
animals by morphine; whilst 
ergot and belladonna, by con- 
tracting its vessels, may help 
in removing various condi- 
tions of debility. Certain ner- 
vous centres are stimulated 
by certain drugs. Thus, atro- 
pine stimulates the respiratory 
centre, the indirect emetics 
stimulate the vomiting cen- 



II. Special Sedatives. 

1. Nervous System. The 
best sedatives to the brain 
are undoubtedly those drugs 
which diminish its blood sup- 
ply and so cause sleep. Co- 
nium is held to exert a spe- 
cially sedative effect on the 
great motor ganglia. [It is 
now generally held that the 
bromides and chloral cause 
anremia of the cerebral cen- 
tres, and thus favor physio- 
logical sleep.] 



The principal spinal seda- 
tives are Calabar bean, bro- 
mide of potassium, chloral, 
methyl conia, and gelsemium, 
which powerfully depress the 
reflex functions of the cord. 

The respiratory centre is 
depressed by chloral hydrate, 
hydrocyanic acid, amyl ni- 
trite, aconite, opium [alco- 
hol], etc. 

An interesting selective ac- 
tion of a sedative or paralyz- 



TONICS. 



8T 



tre, strychnine the vaso- 
motor centre, etc. The ear- 
ringing property of quinine 
is probably due to an irrita- 
tive action on the auditory 
nerve, digitalis stimulates the 
vagus, whilst jaborandi and 
muscarin confine that action 
to the intra-cardiac inhibitory 
apparatus. The sialagogue 
action of jaborandi is be- 
lieved to be due to a stimula- 
tion of the periphery of the 
salivary nerves. 

2. Cardiac and Vascular 
Stimulants. The general 
stimulants already enumerat- 
ed undoubtedly stimulate the 
heart, and the class of drugs 
of which digitalis is the type 
have been already considered 
under cardiac tonics. Opium 
is decidedly a vascular stimu- 
lant. 

3. Digestive and Secretory 
Stimulants. The stomach 
may be stimulated by ginger, 
capsicum, pepper, and the 
like ; whilst cholagogues, diu- 
retics, purgatives, and dia- 
phoretics may be held to 
stimulate the liver, kidneys, 
intestines, and skin, by pro- 
moting or exciting their re- 
spective functions. 



ing nature is exerted by the 
following drugs on the folio w- 
ing nerves. Atropine para- 
lyzes the intra-cardiac inhib- 
itory apparatus and the ter- 
minal fibres supplied by the 
third nerve to the iris. Co- 
nium paralyzes the third 
nerve, gelsemium the sixth, 
and croton chloral the fifth. 
Atropine also exerts an in- 
hibiting influence upon the 
secretory nerves of the sub- 
maxillary gland etc. 

2. Cardiac Sedatives. The 
principal cardiac sedatives or 
depressants are aconite [vera- 
trum viride], tobacco, colchi- 
cum, chloral, chloroform, and 
potassium nitrate. 



3. Digestive and Secretory 
Sedatives. A sedative action 
on the stomach may be pro- 
duced by hydrocyanic acid, 
bismuth, alkalies, arsenic 
and silver, generally in 
small doses ; whilst counter- 
irritation over the epigastric 
region is often an effectual 
means for the relief of pain. 



TONICS. 



The word tonic is undoubtedly vague from the strictly 
scientific stand-point, but we may congratulate ourselves that 
zeal for more precise nomenclature lias not yet succeeded in 
depriving us of a term which has now included so many asso- 



88 TONICS. 

ciations of an empirical kind. The best example of tone 
probably is the gentle and permanent contraction of the mus- 
cular tissue, which is kept up in the healthy body by the 
central nervous system, and which, when suspended by dis- 
ease, is familiar to us all in the flaccid and powerless limb of 
paralysis, and an appropriate remedy is found in electricity, 
which improves the nutrition and status of the part. We 
have vascular tone also, in which the due calibre of the 
arteries is regulated by the action of the vaso-motor nerves, 
and were we asked to name two touic remedies, which rein- 
force these important functions, we might unhesitatingly 
point to strychnine, which aids the nervous tone, and digi- 
talis, which raises the arterial tension by stimulating the 
vaso-motor centre. 

But treating our heading in a more general sense, we are 
justified in calling anything a tonic which improves the gen- 
eral health, and thus an emetic, or a purgative, or a nar- 
cotic, or a sedative, may really have tonic properties by re- 
moving obstruction or irritation and giving rest to fatigued 
or worn-out organs. The best of all tonics, after all, are 
those which cannot well be included in any therapeutical 
tables ; for what can equal the bracing properties of sea- 
bathing, of change of air and scene, of the keen whiff of 
exhilarating ozone on a Swiss glacier or a Scotch moor, of a 
day's hunting or shooting, or a ramble along a good trout 
stream when fish are well on the take ? A good dinner, 
with a glass of good wine, cheerful society, the stimulus of 
hope, even the rousing effect of a sudden reverse of fortune, 
may be often more successful than mere drugs ; but in con- 
sidering the varying modes of treatment for debility in its 
many forms, we may usefully divide our therapeutic resources 
in the following way : — 

I. Nervine Tonics. 
Physiological. Therapeutical. 

1. First among these we 1. Under certain condi- 

may rank agents acting di- tions of mental excitement 

rectly on the brain, reducing or worry or debility, no tonic 

its blood supply and giving can be so good as a sound 

it rest. [Allaying its excita- night's rest, and the narcotic 

bility and favoring normal class of remedies act well by 

nutrition.] supplying this. 



TONICS. 



89 



2. Then, again, certain 
drugs act on special centres ; 
thus, strychnine and digitalis 
stimulate the vasomotor cen- 
tre, atropine the respiratory 
centre ; and strychnine stim- 
ulates the spinal cord. 

Finally, we have those 
substances generally known 
under the somewhat vague 
title of nervine tonics. These 
are principally metals, such 
as arsenic, phosphorus, zinc 
oxide, and zinc sulphate : but 
quinine and ammonium chlo- 
ride have also good right to 
be included in the list. 



2. Strychnine and nux 
vomica are of great service by 
aiding the circulation through 
the vaso-motor centre, and 
helping the spinal cord to re- 
sume its full functions when 
it is weakened by any debili- 
tating cause. The nervine 
tonics are used not only in 
simple debility, but in spe- 
cial conditions of nervous 
weakness. Thus quinine, 
arsenic, and even ammonium 
chloride are of service in neu- 
ralgia, probably by giving in- 
creased tone to sensory nerves; 
the zinc salts are useful in the 
irregular muscular contrac- 
tions of chorea, and in the 
loss of the presiding nervous 
control which characterizes 
hysteria. 



II. Vascular Tonics. 



This class of remedies may 
act in three different ways. 

1. On the heart itself, 
bracing up and improving 
the condition of tone of its 
muscular fibre and slowing 
its action so as to give it in- 
creased rest. Digitalis stands 
first on the list. [Strychnine 
is a valuable cardiac tonic, 
so also are sparteine sulphate 
strophanthus, etc.] 

2. Those which act more 
particularly on the vessels, 
raising arterial tension by 
contracting the muscular tis- 
sue of which their walls are 
largely composed. Here again 
digitalis comes into play, but 



1. We see the great bene- 
fit of this division more espe- 
cially in heart disease, where 
the pulse is feeble and irregu- 
lar, and in functional derange- 
ment of cardiac action from 
feebleness of the muscular 
structures of the heart. 



2. These also act well in 
improving the general tone 
of local circulation, bracing 
up the vessels, and removing 
oedema and passive conges- 
tion. 



8* 



90 



TONICS. 



3. In anaemia, where the 
blood is poor in red corpus- 
cles and haemoglobin, in chlo- 
rosis, in the debility follow- 
ing loss of blood, etc. etc., 
these haematinic remedies, as 
they have been called, are 
of essential service, whilst in 
neuralgia they act well by 
giving the enfeebled sensory 
nerves the healthy stimulus 
of better blood. 



we also have ergot, belladon- 
na, etc. etc. 

3. Those which act direct- 
ly on the blood, increasing 
the number of red corpuscles 
and the amount of haemoglo- 
bin which they contain. Iron 
[manganese], phosphorus, ar- 
senic, and cod-liver oil have 
been proved, by careful in- 
vestigations and by direct 
measurement, to have this 
property [which has also been 
shown by Keyes to belong to 
mercuric bichloride given in 
small doses.] 

III. Digestive Toxics. 

In general debility and 
feebleness, convalescence 
from acute illness, and want 
of tone, we know how much 
more hopeful we become 
when our patient is able to 
relish and digest his food, 
and we also know how great 
is the aid given by small 
doses of alcohol with the 
meals, in helping the weak 
stomach to do its work. For 
irritable dyspepsia, with a 
red tongue, the ordinary 
tonics only do harm, and 
when the tongue is foul and 
loaded, a mild course of pur- 
gative will remove unhealthy 
mucus and enable digestion 
to be satisfactorily accom- 
plished. 



Of the importance of this 
division there can be no doubt, 
when we consider that life 
itself, as well as sound health, 
depend on the consumption 
and due assimilation of a 
well-arranged dietary. Bit- 
ters are generally looked 
upon as the type of tonics, 
and there is no doubt that 
they increase the feeling of 
appetite and augment the 
secretion of saliva, and possi- 
bly that of the gastric juice. 

Then, again, the best tonic 
to an irritable stomach may 
be remedies such as bismuth 
and hydrocyanic acid, which 
calm and soothe, and enable 
the mucous membrane to re- 
sume its function. Gentle 
purgatives may also act as 
tonics, and acids and alkalies, 
which both check inordinate 
acid secretion and encourage 
its flow. 



ACTION OF THERAPEUTIC AGENTS. 



91 



[SUMMARY OF THE ACTION OF THERAPEUTIC 
AGENTS. 

Remedies may be used with a therapeutic effect for the 
purpose of favorably modifying : — 



Environment 



Nutrition 



Innervation 



Circulation 



Functional 

activity 
(specifically). 



(Antiseptics, and hygienic measures). 
Food. 
Appetite. 
Digestion. 
Absorption. 
<{ Secretion. 
Blood-erasis. 
Respiration. 
Bodily heat. 
Organic status. 

Sensation (general and special). 
Motility. 
Condition of nervous structure. 

\ Stimulant. 

(Sedative. 
Arterial contraction. 
[ Volume of blood. 
Stomach. 



Action of heart 



Liver. 

Kidneys. 
Heart. 
Lungs. 

Nervous struc- 
tures, etc. 



< 



Vomiting. 
Purging. 
Counter-irrita- 
tion, etc. 



They also indirectly influence development, and in an un- 
known manner act upon certain morbid states, as cinchona 
in malaria, and mercury in syphilitic dyscrasia. 

The following classification (that of Dr. H. C. Wood) 
appears to be more scientifically arranged than any other 
that has been offered : — 



92 CLASSIFICATION OF DRUGS. 



CLINICO -PHYSIOLOGICAL CLASSIFICATION 
OF DRUGS. 1 

A. — Extraneous or Non-Systemic Remedies. 

Family I — Antacids. Liq. Potassas ; Sodium and 
its salts ; Lime-salts and preparations. 

Family II Anthelmintics. Spigelia ; Azedarach ; 

Chenopodium ; Brayera ; Santonica; Aspidium ; 
Pepo; Oleum Terebinthinae ; Granatum ; Thymol ; 
Kamala. 

Family III. — Digestants. Pepsinum Saccharatum ; 
Extractum Malti ; Acidum Hydrochloricum. 

Family IV Absorbents. Carbo Animalis Purifiea- 

tus ; Carbo Ligni. 

Family V Disinfectants. Hydrargyrum Chloridum 

Corrosivum ; Acidum Carbolicum ; Potassii Per- 
manganas ; Aqua Chlori ; Calx Chlorata; Liq. Sodae 
Chloratae ; Ferri Sulphas; Plumbi Nitras ; Sodii 
Boras; Acidum Boricum; Acidum Sulphurosum. 

B. — Systemic Remedies. 

Class I.— GENERAL REMEDIES. 
Order I Nervines. 

Family I — Antispasmodics. Asafoetida ; Camphora; 
Camphora Monobromata ; Humulus; Lupulinum ; 
Moschus ; Spiritus iEtheris Compositus. 

Family II Anaesthetics. JEther; Chloroform ; Ni- 
trogen Monoxide. 

Family III — Somnifacients (Hypnotics). Opium 
and its Preparations ; Chloral ; Lactucarium ; Aci- 
dum Hydrobromicum ; Bromides. 

Family IV Cerebral Excitants (Delirifacients). 

Atropine Sulphas; Belladonna Preparations ; Can- 
nabis Indica and Americana ; Stramonium; Hyoscy- 
amus ; Erythroxylon. 

1 [In considering the remedies systematically in this work, it has 
been thought best not to follow any therapeutical classification, as 
none that have been offered are free from objection, and the advan- 
tages of an alphabetical arrangement for the convenience of refer- 
ence are too obvious to demand discussion.] 



CLASSIFICATION OF DRUGS. 93 

Family V Excito-Motors. Nux Vomica, Strych- 

nina. 
Family VI Depresso-Motors. Acidum Hydro- 

bromicum and Bromides ; Amyl Nitris ; Potassii 

Nitras; Physostigminas Salicylas ; Lobelia; Gelse- 

mium ; Tabacum ; Conium. 

Order II — Cardiants. 

Family I. — Cardiac Stimulants. Alcohol ; Ammo- 
nium Preparations ; Digitalis ; Caffeine ; Scoparius 
(Sparteine Sulphas). 

Family II Cardiac Depressants. Aconitum, 

Veratrum Viride ; Antimonium salts ; Arnicae 
Flores ; Arnica? Radix ; Acidum Hydrocyanicum ; 
Vegetable acids ; Veratrina. 

Order III Nutrients. 

Family I. — Astringents. Acidum Gallicum; Acidum 
Tannicum; Rosa Centifolia; Rosa Gallica; Geran- 
ium; Rhus Glabra ; Salts of Argentum; Alumin- 
ium; Bismuthum; Cuprum; Cerium; Zincum. 

Family II. — Tonics. Ferrum ; Manganese; Phospho- 
rus; Zinci Phosphidum; Mineral acids. 

Family III. — Alteratives. Arsenium preparations ; 
Hydrargyrum salts; Oleum Morrhuae; Acidum 
Phosphoricum ; Colchici Semen ; Colchici Radix; 
Sarsaparilla; Guaiac; Preparations and Salts con- 
taining Iodum. 

Family IV. — Antiperiodics. Cinchona; Eucalyptus; 
Acidi Arseniosi. 

Family V. — Antipyretics. Acidum Carbolicum ; 
Acidum Salicylicum; Quinina; Oleum Gaultheria3. 

Class II.— LOCAL REMEDIES. 

Family I — Stomachics. Pimenta; Gentiana ; Ca- 
lumbo; Cardamomum; Capsicum; Piper; Myris- 
tica; Macis; Quassia; Cinnamomum; Oleum Cary- 
ophylli ; Zingiber. 

Family II.— Emetics. Ipecacuanha; Apomorphina? 
Hydrochloras ; Sinapis; Zinci Sulphas; Cupri Sul- 
phas. 



94 CLASSIFICATION OF DRUGS. 

Family III — Cathartics. Aloes, Rheum, Senna, 
Jalapa ; Colocynthis, Scammonium ; Cambogia ; 
Podophyllum; Elaterium ; Oleum Tiglii ; Fran- 
gula; Cassia Fistula; Manna; Tamarindus; Euony- 
mus; Iris; Magnesii Sulphas; Magnesii Citras ; 
Sodii Phosphas ; Magnesii Carbonas ; Potassii et 
Sodii Tartras. 

Family IV — Diuretics. Scilla ; Scoparius; Spiritus 
iEtheris Nitrosi ; Caffeina; Buchu ; Uva Ursi ; Jun- 
iperus; Chimaphila ; Oleum Erigerontis; Oleum 
Santala ; Terebinthina ; Copaiba ; Cubeba ; Can- 
tharis. 

Family V Diaphoretics. Pilocarpus ; Alcohol ; 

Liquor Ammonii Acetatis ; Spiritus -ZEtheris Ni- 
trosi ; Pulvis Ipecacuanhas et Opii. 

Family VI Expectorants. Ipecacuanha ; Lobelia ; 

Antimonii et Potassii Tartras; Grindelia ; Senega; 
Ammoniac; Tolu; Allium; Scilla; Eucalyptus; 
Ammonii Chloridum ; Ammonium Carbonas. 

Family VII. — Emmenagogues. Myrrha; Oleum Sab- 
ina; Oleum Rutas; Cantharides ; Oleum Tanaceti. 

Family VIII — Oxytocics. Ergota; Gossypii Radicis 
Cortex ; Quinina ; Ustilago. 

Family IX Sialagogues. Pellitory ; Pilocarpus. 

Family X Errhines. Cubeba. 

Family XI Epispastics. Ceratum Cantharidis ; 

Collodium cum Cantharide. 

Family XII Rubefacients. Capsicum ; Oleum 

Sinapis volatile ; Oleum terebinthinoe; Aqua Am- 
monias ; Pix Burgundica; Pix Canadensis. 

Family XIII. — Escharotics. Potassa; Acidum Ar- 
seniosum ; Liquor Hydrargyri Nitratis ; Acidum 
Chromicum ; Acidum Aceticum, etc. 

Family XIV. — Demulcents. Acacia; Linum ; Ulmus. 

Family XV Emollients. Oleum Theobromas; 

Adeps ; Petrolatum. 

Family XVI Diluents. Aqua. 

Family XVII Protectives. Collodium ; Liquor 

Gutta Perchas ; Emplastrum Saponis. 



DRUGS AND PREPARATIONS 

OFFICINAL IN 

THE UNITED STATES PHARMACOPEIA. 



ABSINTHIUM—WORMWOOD. 

[ The leaves and tops of Artemisia Absinthium, Linne (2V. 0. Composite). 

Wormwood is one of the ingredients of Vinum Aromaticum, 
U. S. P. (Lavender, Origanum, Peppermint, Rosemary, Sage, 
Wormwood aa one part, Stronger white wine q. s. ad 100 
parts.) It is a stimulating dressing for venereal ulcers. It 
may be used internally as a bitter tonic, dose 5j to §j (4 to 
32 G.).] 

Wormwood was formerly used as a bitter tonic and an- 
thelmintic, but it has now quite disappeared from practice. 
Its prolonged use as a beverage, in the form of liquor, has 
been shown to produce a condition of enfeeblement and 
irritability of the nervous system, with a tendency to epilep- 
tiform convulsions. . 

[In combination with other herbs, it is occasionally used 
in domestic practice in the form of infusion under the name 
of German Tea as a stomachic ; and sometimes for intestinal 
worms in children. Dose from fifteen to forty grains (1 to 
2.5 G.), preferably in infusion or decoction (1 to 16). Its 
tonic effects are due to a bitter principle, absinthin. The 
plant also contains a volatile oil, which is a narcotic poison, 
producing insensibility, convulsions, and coma ; and the use 
of absinthe as an intoxicating drink causes epilepsy and de- 
pression of the vital powers.] 

[ABSTRACTA—ABSTRACTS. 

This class of preparations has been added to the officinal 
list in order to atone for the uncertainty of strength of the 
ordinary commercial solid extracts, by furnishing in a pow- 



96 GUM ARABIC. 

dered form preparations which bear a definite relation to the 
crude drug. While the fluid extracts represent the virtues 
of the drugs, minim for grain (or more correctly ccm. for 
gramme), the abstracts represent twice the strength of the 
crude drug (200 per cent.). They are prepared by exhaust- 
ing the drug with a menstruum which dissolves the active 
principles, then evaporating the extract thus obtained, and 
adding enough sugar of milk, with trituration, to make the 
product one-half the weight of the original drug. The pow- 
der should be preserved in a well-stopped bottle. The 
officinal abstracts are — 

Abstractum Aconiti usual dose gr. I to ij (.01 to .12 G.) 

" Belladonnas " gr. ± to iij (.03 to .20 G.) 

" Conii " gr. v to viii (.30 to .50 G.) 

" Digitalis " gr. ^ to j (.03 to .06 G.) 

" Hyoscyami " gr. iij to v (.20 to .30 G.) 

" Ignatise " gr. j (.06 G.) 

" Jalapse " gr. viii to x (.45 to .65 G.) 

" Nucis Vomicae " gr. ^ to ij (.03 to .15 G.) 

" Podophylli " gr. v to x (.30 to .65 G.) 

" Senegse " gr. v to x (.30 to .65 G.) 

" Valerianae " gr. xv to xlv (1. to .3 G.)] 



ACACIA—GUM ARABIC. 

[A gummy exudation from Acacia verek and other species of Acacia. 
(N. 0. Leguminosce, Mimosece.) 

Officinal Preparations, U. S. 

Mueilago Aeaeise (Acacia, 34 parts; Water, 66), 
used as a vehicle. 

Syrupus Aeacise (Mucilage, 25 parts ; Syrup, 75), 
used as a vehicle. 

Also enters into Mistura Amygdalae, Pulvis Cretae Com- 
positus, Mistura Cretae, and Mistura Glycyrrhizaa Composita, 
and is used as an excipient and dusting-powder for pills.] 

Gum is demulcent, and in the form of mucilage is much 
used for the suspension of bulky and insoluble powders, as 
well as to prevent the precipitation of the resin, which en- 
sues when such substances as tincture of myrrh, tinct. can- 
nabis Indicae, etc., are added to water [and also to make 
emulsions of oil and water]. 



ACETIC ACID. 97 

[Gnm-Arabic solution, made thin and flavored to taste, 
may be given as a drink in fevers, in angina, in gastro- 
enteric inflammation and dysentery. The trochees are pop- 
ular confections and are useful in pharyngeal irritation. It 
is believed to have some nutritive value.] 



[ACETA— VINEGARS. 

The officinal vinegars are : — 

Acet-um Lobelice, Acetum Sanguinariae, 

Acetum Opii, Acetum Scillse. 



ACIDUM ACETICUM GLACIALE—GLACIAL 
ACETIC ACID. 

Nearly, or quite, absolute acetic acid, U. S. P. 

ACIDUM ACETICUM— ACETIC ACID. 

\_A liquid composed of 36 per cent, of absolute acetic acid and 64 per cent, 
of water. Sp. grav. 1.048. 

Aeidum Aceticum Dilutum. Acetic acid 17, water 
83, contains 6 per cent, of absolute acetic acid. Used in pre- 
paring the Aceta. 

Also enters into Emplastrum Ammoniaci, Emp. Ararao- 
niaci cum Hydrargyro, Extractum Colchici Radicis, Mis- 
tura Ferri et Ammonii Acetatis, Liquor Ammonii Acetatis, 
Syrupus Allii, and Syrupus Scillse. 

Poisoning- and Antidotes. 

When acetic acid is swallowed there is experienced great 
heat and burning pain in the stomach, vomiting of sour liquid, 
purging, convulsions, terminating finally in coma and death. 

At the autopsy the mouth and fauces are found to be 
brownish, lingual papillae swollen, with sloughing of mucous 
membrane of pharynx. The stomach is livid or blackened, 
and its capillaries injected. 

In poisoning by acetic acid, alkalies or their carbonates 
may be given, properly diluted, and vomiting encouraged by 
large draughts of warm water containing milk or soap.] 

External Action. 
Strong, or glacial, acetic acid is a favorite and very suc- 
cessful application to warty groivths, whether of venereal 
9 



98 ACETIC ACID. 

origin or not. The little tumor is touched several times 
with a glass rod, or brush, or a piece of wood, dipped in the 
acid, care being taken that none of the fluid trickles down 
over the neighboring structures. A few repetitions of this 
process will generally prove effectual. [It has been used 
with success for nasal hypertrophies, and for injection into 
nasal polypi.] It is also topically used in some obstinate 
forms of skin-disease, and more especially the varieties of 
tinea comprised under the term ring-worm. The acid proba- 
bly acts by directly attacking and destroying the parasitic 
growth on which the troublesome affections depend. Acetic 
acid is also occasionally applied to corns. 

Internal Use. 

Acetic acid is seldom used internally, although it forms 
an agreeable and effectual remedy for the checking of night 
sweats, and Graves used thus to prescribe it. 

Vinegar, the strength of which corresponds pretty accu- 
rately with the dilute acid, is purely a domestic remedy for 
headache, hysteria, and other allied conditions. 

[Vinegar, more or less diluted, is a favorite domestic appli- 
cation in head-ache, sprains, or bruises, and sun-burn; it is 
also used as a clyster against ascarides. It may be given 
as a gargle for tonsillitis, and a refrigerant drink in fevers; 
and in these cases it is frequently applied to the surface of 
the body, with a sponge, as a means of reducing a high tem- 
perature. In small amounts vinegar aids digestion, but in 
excess it is said to produce degeneration of the gastric tu- 
bules and fibroid thickening of the stomach. It is supposed 
to reduce the proportion of fibrin in the blood. It has been 
pronounced to be an efficient remedy in scurvy, in combination 
with nitre (^j to Oj), of which an ounce may be given four 
times daily. As an antidote to caustic alkalies, vinegar is 
the most covenient form of acid to give, as it is found in 
every house. It can be freely administered, diluted with 
water, without fear of bad results. 

The formula for Linimentum Terebinthinm Aceticum (N. 
F.), a popular liniment for chronic rheumatism, will be 
found at the end of the book, in the Formulary of the 
American Pharmaceutical Association.] 



ARSENIC. 99 

ACIDUM ARSENIOSUM— ARSENIOUS ACID 

(As 2 3 ; 197.8.). 

[Officinal Preparations, U. S. 

Liquor Aeidi Arseniosi (one per cent.). Dose, n^iij 
to x (.20 to .00 Gm.). 

Arsenii Iodidum. Dose, gr. -fa (.003 Gm.). 

Liquor Arsenii et Hydrargyri Iodidi (contains 
iodide of arsenic, mercury biniodide, of each, one part in one 
hundred). Donovan's solution. Dose, T^iij to x (.20 to 
.60 Gm.). 

Liquor Potassii Arsenitis. (One per cent, of arse- 
nious acid in combination.) Fowler's solution. Dose, njjij 
to x (.20 to .60 Gm.). 

Sodii Arsenias. Dose, gr. T ^ (.005 Gm.). 

Liquor Sodii Arseniatis. (Sodii arsenias one per 
cent.) Pearson's solution. Dose, nr.v (.30 Gm.). 

Metallic arsenic is inert, and is not used in medicine. 
Arsenious acid is sometimes termed white arsenic, or, sim- 
ply, arsenic, as in the following remarks. It is a corrosive 
poison.] 

Poisonous Effects and Antidotes. 

Poisoning by arsenic is ushered in by [a metallic taste in 
the mouth, salivation, nausea, fainting, great thirst, and a 
burning pain in the stomach, vomiting and diarrhoea. The 
stools are dark colored and very offensive, the urine scanty 
and high colored. The pulse is weak, and often intermits ; 
there is distressing palpitation of the heart, with labored 
respiration and cold sweats. There is prostration, sometimes 
paralysis, and] headache, fever, and disturbed sleep, fol- 
lowed by more acute symptoms and death from collapse — a 
train of symptoms much resembling those met with in cases 
of true cholera. [Such phenomena occurring in the absence 
of any epidemic of Asiatic cholera, and coming on soon after 
eating, in a previously healthy person, should excite suspi- 
cion of arsenical poisoning.] 

After death, there will be the usual pathological appear- 
ance of gastro-enteritis [but without erosion or abrasion, 
and most marked in the stomach, duodenum, and the rectum. 
Sometimes there are few or no morbid appearances in these 
situations ; for instance, where it has been administered in a 



100 ARSENIC. 

vaginal injection. In some cases the gastro-enteric symp- 
toms are not prominent, or are entirely absent, and the 
patient is found to have marked depression of the vital 
powers, and a progressive tendency to coma and collapse, 
showing that the force of the poison has been chiefly ex- 
pended upon the nervous system. Recent researches have 
shown by chemical analysis a relatively larger proportion of 
arsenic in the nervous centres than in other tissues of the 
body.] Frequently we find fatty degeneration of the heart 
and muscles, and parenchymatous degeneration of the liver, 
kidneys, etc. [Arsenic may generally be detected in the 
liver, or contents of the stomach, by Reinsch's or Marsh's 
test. 

The chemical antidotes to arsenious acid are freshly pre- 
pared hydrated sesquioxide of iron, and magnesia freshly 
calcined. The solution of dialyzed iron is a convenient 
antidote for arsenical poisoning. When Fowler's solution 
has been taken the ferric salts are the antidotes. 

We should resort to abundant draughts of sweet milk, 
gruel, decoctions of starch, or oily mixtures; tickling the 
fauces, etc., to induce vomiting; the stomach-pump; emetics 
of sulphate of zinc. Hydrated sesquioxide of iron, newly 
prepared, in large doses, or in the form of dialyzed iron, 
affords the only reliable antidote. The officinal hydrated 
oxide of iron with magnesia is ordered to be prepared by 
adding gradually water containing magnesia, 150 grains, to 
solution of tersulphate of iron, 1000 grains, shaking them 
together until a homogeneous mass results. The solutions 
are to be kept on hand ready for immediate use. 

Calcined magnesia may be used witli advantage, until hy- 
drated peroxide of iron can be procured. Having removed 
the poison by vomiting and purging, we afterwards combat 
any inflammatory symptoms by the usual means, and let the 
patient subsist, for a long time, wholly on the blandest diet. 

Tests for Arsenic. 

In the solid state it can be sublimed by heat. If mixed 
with charcoal, and heated in a suitable test-tube, deoxi- 
dated arsenic will be obtained in the form of a metallic 
coating inside the tube ; and this may be reconverted into 
arsenious acid by urging it in various directions along the 
tube with the aid of a minute spirit-lamp flame ; the facets 
of the crystals thus formed (on the cooler situations) will 



ARSENIC. 101 

be seen in some places with the unassisted eye, but more 
distinctly by means of a four-power lens. 

In solution, ammoniacal nitrate of silver produces a lemon- 
colored (arsenite of silver) precipitate. Ammoniacal sul- 
phate of copper throws down a grass-green (arsenite of 
copper') precipitate. Transmission of sulphuretted hydrogen 
produces a bright-yellow (sulphide of arsenic) precipitate. 
Lime-water precipitates a white (arsenide of calcium) pow- 
der, but this test is not one to be relied upon. 

Marsh's Test Placed with zinc and diluted sulphuric 

acid in the hydrogen apparatus, the arseniuretted hydrogen 
thence arising, when lighted, will deposit metallic arsenic 
on a piece of glass held within the flame. 

Reinsch's Test. — Acidulate the suspected liquid with 
muriatic acid, and boil copper wire, or foil, in it for ten min- 
utes. The arsenic is deposited on the copper as a white 
alloy, from which it can be separated as arsenious acid, by 
subjecting the copper, cut into shreds, to a low red heat in 
the bottom of a small glass tube. 

The precipitates referred to, if washed and dried, may be 
treated as directed above for arsenic in the dry or solid con- 
dition. 

In testing suspected matters obtained from the stomach, 
these, and in cases of death, the viscera themselves, must be 
cut or broken up, and boiled during, at least, three-quarters 
of an hour; if not sufficiently fluid, add distilled water. 
Strain, add a small quantity of potassa, and again boil dur- 
ing a quarter of an hour and filter. If this liquor manifest 
either alkaline or acid reaction, neutralize with potassa, or 
with acetic acid, as may be required; then acidulate it 
faintly with hydrochloric acid. The liquor may now be 
experimented on with the above tests.] 

Local Action*. 

Physiological. Therapeutical. 

Externally applied, arsenic Arsenic has been employed 

causes redness and inflamma- as a caustic in cancer and 

tion of the skin, followed by allied diseases; but not only 

ulceration and sloughing. If is its action difficult to regu- 

we wish to use it as a caustic late, but dangerous symptoms 

we must apply it freely to of poisoning have resulted 

prevent bad results; remem- from the very ready way in 

9* 



. 



102 



ARSENIC. 



bering that if we produce in- 
flammation of a part we check 
its absorptive powers. [It is 
considered safer to limit the 
application to a small surface 
at a time on this account.] 



which it is absorbed by the 
skin. As a more gentle form 
of stimulant, however, it is of 
great service in some chronic 
skin diseases, such as lupus. 



Internal Actions and Uses. 



I. On Brain and Nervous 
System — Arsenic has a tonic 
influence on the nervous sys- 
tem generally. 



II. Circulation and Re- 
spiration. — In small doses 
arsenic may stimulate cardiac 
action in a slight degree ; and 
the experience of the arsenic- 
eaters of Styria shows that 
its use improves their wind, 
and enables them to undergo 
great exertion without fa- 
tigue. This fact, which was 
formerly denied, has been 
placed beyond all doubt by 
the observations of Macla- 
gan, who, after seeing an 
arsenic -eater consume his 
dose, detected the presence 
of the metal in the urine. 
Either arsenious acid or or- 
piment is used, and the largest 
dose is said to be 14 grains, 8 
grains having been actually 
eaten in presence of a com- 
petent witness. It is stated, 



I. This may in some mea- 
sure explain its antiperiodic 
properties, for it is well 
known that arsenic is only 
second to quinine in its power 
of arresting the various mani- 
festations of ague. 

It is also a valuable remedy 
in neuralgia, and chorea may 
frequently be cured by full 
doses. 

II. Arsenic is of service 
in asthma, hay-asthma, per- 
haps by calming irritability 
of the vagus, and some forms 
of chronic bronchitis and 
chronic phthisis, and has 
been found to act well by 
the inhalation of spray. 

The Monte Dore waters, 
so much recommended in 



asthma. 



believed to owe 



their efficacy to the arsenic 
which they contain. 



ARSENIC. 



103 



however, that only persons of 
strong constitution can bear 
this habit. 

III. On the Secreting Or- 
gans 1 . Digestive Tract. 

In small doses arsenic stimu- 
lates the appetite and in- 
creases the digestive powers, 
but if used more freely symp- 
toms of irritation set in, 
which may terminate in gas- 
troenteritis. [Some patients 
cannot take the smallest doses . 
without great systemic dis- 
turbance. It is advisable to 
begin with minute doses and 
cautiously increase, watching 
the effect.] 



III. Ringer recommends 
small doses of arsenic — 1. In 
a form of irritative dyspepsia 
with red tongue and promi- 
nent papilla?, in the morning 
vomiting of drunkards, and 
in that variety of diarrhoza 
which leads to the evacu- 
ation of the bowels imme- 
diately after eating. That 
the nutrition of the skin is 
profoundly affected by ar- 
senic, is proved by experi- 
ments which show that des- 
quamation of the epidermis, 
and degeneration and partial 
solution of the protoplasm of 
the cells of the cutis vera, re- 
sulted in frogs poisoned with 
the drug. We may explain 
the success of arsenic in cu- 
taneous disorders either by 
its influence on the nutrition 
of the cell-growth of the skin, 
or by its action on the ner- 
vous system, it being an un- 
doubted fact that its curative 
powers are almost restricted 
to those diseases which are of 
neurotic origin. Excellent 
though its effects frequently 
are, it will often prove dis- 
appointing, and will fail to 
cure the disease for which it 
is given. But in psoriasis, 
if we get the case early, and 
treat it regularly and rigidly, 
continuing the administra- 
tion of the drug in small 
doses for some time after the 



104 



ARSENIC. 



2. Cutaneous. — Arsenic 
occasionally causes irritation 
and tingling of the skin, and 
even the appearance of ecze- 
matous and occasionally her- 
petic eruptions. 



3. Liver. — Arsenic in poi- 
sonous quantities causes, like 
phosphorus, fatty or paren- 
chymatous degeneration of 
the liver. 

4. On Urine Nothing 

special has been described 
[except that the kidneys and 
liver are the principal chan- 
nels for the discharge of the 
poison from the circulation.] 



eruption has disappeared, we 
may usually hope for good 
results, remembering that re- 
lapses are extremely common 
in this disease. Some au- 
thorities hold that in order 
to get full value from the 
use of arsenic, we must pro- 
duce physiological symptoms, 
but my own experience is en- 
tirely opposed to this. 

2. In dry scaly affections 
of the skin, such as psoriasis, 
in the dry stages of eczema 
and impetigo, in pemphigus, 
and in lichen, arsenic acts 
most admirably ; but we must 
be careful never to give it 
during the acute stage of any 
skin affection, as in these 
circumstances, it is invariably 
found to aggravate the symp- 
toms. Arsenic is much val- 
ued by Balfour and others 
in chronic rheumatism, and 
more especially rheumatoid 
arthritis. 

3. [Arsenic in small doses 
is a valuable stimulant to the 
hepatic tissue changes, and is 
useful in incipient cirrhosis 
and in certain forms of intes- 
tinal indigestion.'] 

4. Dr. Lauder Brunton re- 
cords an interesting case in 
which arsenic cured albumi- 
nuria in a young man, due 
probably to imperfect pan- 
creatic digestion of albumen. 



ARSENIC. 105 



Mode of Examination. 

Arsenic is rather slowly removed from the body by the 
intestines, the urine, and perhaps the bile and the skin. 
Traces have been found in the urine sixteen days after in- 
gestion. 

Mode of Administration, Cautions, etc. 

Persons vary much in their susceptibility to arsenic, and 
we must invariably begin its use with caution, keeping in 
mind that children bear it well, and that a child of five can 
.bear with impunity as large a dose as an adult. [Two 
grains of arsenious acid have caused death, according to Dr. 
Taylor.] 

We must also remember that, although the Styrian peas- 
ants can accustom themselves to large and increasing doses, 
the experience of medical practice shows that, after a certain 
time, patients taking this drug are liable to show some of the 
following symptoms : Smarting and itching about the con- 
junctivae, with oedema, pain in the stomach, vomiting and 
diarrhoea, white tongue, and general digestive derangement ; 
and when these indications of "accumulation" occur, it is 
not necessary to suspend the remedy altogether, but merely 
to diminish the dose. 

The probabilities of these unpleasant symptoms are much 
lessened, however, by advising that the dose should always 
be taken after a meal. 

The mode in which arsenic is usually given is in the form 
of liq. arsenicalis [Fowler's solution — Liq. Potass. Arsenitis, 
U. S.], which is merely a solution of arsenious acid in car- 
bonate of potash flavored with sp. lavend. co., containing gr. 
ss in f*3j, and of which the dose is, as a general rule, from 
iri^ij to n^v (.13 to .82 Gm.) ; but in some obstinate affec- 
tions, like chronic rheumatic arthritis, it is requisite to push 
the quantity as far as ni^x or even ni^xv (.65 to 1. Gm.). 
In skin diseases I am strongly in favor of beginning with a 
large dose, and pushing the drug vigorously. Small doses 
seem more likely to provoke irritation than large. Being 
almost tasteless, liq. arsenicalis is best given simply in water. 

The liquor arsenici chloridi, sodii arsenias, and ferri arse- 
nias are rarely used ; and the liquor arsenici et hydrargyri 



106 BENZOIC ACID. 

ioclidi [Donovan's Solution], which was supposed to have 
a special influence over syphilitic skin diseases on account 
of its combination of arsenic with iodine and mercury, has 
gone much out of fashion in these days. Dose, 10 to 30 
minims (.65 to 2. Gm.). [The iodide of arsenic is sometimes 
used as an ointment in skin affections (gr. iij to 3j). Simple 
ointment with arsenious acid (gr. j to §j) has been highly 
recommended as an agreeable substitute for sulphur ointment 
in the treatment of scabies.'] 

I£. Hydrargyri chloridi corrosivi 5uss or 101 Gm. 
Hydrargyri sulphidi rubri gr. xl " 2 60 " 

Acidi arseniosi ^j " 41 " M. 

S. To be made into a paste with a little water, and then 
applied with a brush. 

Useful in cases of lupus. 

I£. Vini ferri 

Liquoris potassii arsenitis 

Syrupi aurantii 

Aquae anethi q. 

Pro dosi. 

Useful in eczema, psoriasis, etc. 



m 


or 4 Gm. 


"liij 


" 20 " 


f5J 


" 4 


ad f3j 


" 32 " 



[ACIDUM BENZOICUM—BENZOIC ACID 
(HC.H 5 2 ; 122). 

In white lustrous scales or friable needles, soluble in 500 parts of cold 
water, or 3 parts of alcohol and in 15 parts of boiling water, or I part 
of alcohol. Dose, gr. x—xxx (0.65-2 Gm.). 

(See Benzoixum.)] 

[ACIDUM BORICUIV1— BORIC ACID (BORACIC 
ACID, Ph., 1870) (H 3 B0 3 ; 62). 

Transparent, colorless, six-sided plates, soluble in 25 parts of water and 
15 parts of alcohol at 590 f mj and in three parts boiling water or 5 
ports boiling alcohol. The alcoholic solution burns with a flame tinged 
tuith green. Dose, gr. v-xx (0.30-1.30 Gm.). 

Officinal Salts. 

Sodii Boras— Borate of Sodium (Borax) gr. v- 

xxx (.30-2 Gm.).] 

Boric acid may be obtained by the decomposition of borax 



BENZOIC ACID. 107 

by sulphuric acid. It occurs in white, shining, scaly crys- 
tals, with no smell, and a feeble acid taste. Dissolved in 
alcohol, it imparts a characteristic green tinge to its flame • 
it is soluble, also, though to a less extent, in water (20 parts 
cold, or in 3 of hot). Borax, but to a higher degree, boric 
acid has decided antiseptic power, arresting fermentation 
and putrefaction by destroying the organic ferments upon 
which their processes depend.] This is an excellent anti- 
septic application to superficial granulating surfaces, used as 
a lotion, 40 per cent, saturating water, or as boric lint, 
made by soaking lint in a hot 30 per cent, solution, and 
allowing it to dry, or an ointment : Boric acid and white 
wax, 20 parts each ; almond oil and paraffine, 20 parts each. 
Glycerine is also an excellent solvent. Free application of 
the saturated solution is the best remedy for the fetid per- 
spiration of the feet which often causes so much annoyance. 
[In the aphthous sore-month of children, in which it acts in 
a similar manner, borax and sugar has long been a favorite 
remedy, and a solution of borax forms a common wash for 
use in disorders of the hairy scalp, and in scaly eruptions. 
In pruritus, tinea circinata, pityriasis versicolor, etc., boric 
acid solutions are of much service. 

Boric acid, finely levigated, has been used of late years 
with great success, insufflated into the auditory canal, in 
cases of chronic suppurative discharges from the ear. It 
appears to be perfectly free from irritation, and quickly re- 
duces the offensive character of the discharge as well as its 
quantity. Boric acid has also been used in general surgery 
as a dressing for wounds, and Mr. Lister employs it to a con- 
siderable extent in his system of dressings. 

Boric acid and borax have been used in lozenges for public 
speakers in order to prevent hoarseness, but are seldom em- 
ployed internally in any other form, although the latter has 
been highly recommended in the uric acid diathesis in doses 
of thirty or forty grains.] 



108 CARBOLIC ACID. 



[ACIDUM CARBOLICUM CRUDUM— CRUDE 
CARBOLIC ACID. 

A liquid obtained during the distillation of coal-tar between the tempera- 
tures of 170O and 19(P C. (338° and. 374° F), and containing car- 
bolic and cresylic acids in variable proportion, together with other sub- 
stances, U. <S. {used only as an external remedy or for disinfecting pur- 
poses) . 

ACIDUM CARBOLICUM—CARBOLIC ACID. 

[Syn.— Phenol. C 6 H 5 HO ; 94.] 

A product of the distillation of coal-tar, between the temperatures of 180° 
and 190O C. (35(P and 374© F.), U. S. 

Dose, gtt. i-ij (.06 to .13 Gm.) 

Officinal Preparation, U. S. 
Unguentum Aeidi Carbolici (10 per cent.). 

Poisoning. 

In poisonous doses it causes burning and pain in the 
stomach, mucous vomiting, clammy, cool skin, difficult 
breathing, insensibility, contracted pupils, collapse, and 
death. Post-mortem examination discloses catarrh of the 
mucous membrane of the stomach, inflammation of the kid- 
neys, dark and imperfectly coagulated blood. 

Antidotes. 

Saccharate of calcium (which may be extemporaneously 
prepared by adding calcium hydrate 1 pt. to sugar 3 pts.), 
calcium carbonate, and calcined magnesia in lime-water, are 
probably the best antidotes. Alkalies, soap, or the fixed oils 
may be given, with demulcent drinks, and the stomach eva- 
cuated with a pump or siphon, as the local effect of the acid 
will generally prevent emetics from acting. Atropine and 
cardiac stimulants are required to obviate the tendency to 
collapse. Nitrite of amyl might be cautiously inhaled ; or 
an intravenous injection of diluted aqua ammonise admin- 
istered. The soluble sulphates, as the sulphate of magne- 
sium, of sodium, etc., are very useful for carrying off the 
carbolic acid from the system.] 



CARBOLIC ACID. 



109 



Local 

Physiological. 

Carbolic acid is, in the 
first place, an antiseptic, 
from its power of destroying 
the minuter forms of animal 
and vegetable life. 

It is also a useful applica- 
tion in tinea tonsurans, both 
as destroying the microspores 
and preventing their develop- 
ment ; but, as redevelopment 
very rapidly takes place, we 
must apply our remedy every 
six hours, and continue its 
use for at least a fortnight 
after the apparent cure-. 

Injections ( rr^ss) of pure 
acid into various parts of the 
tumor are very useful in 
naevus, and also in varicose 
veins. [Similar injections of 
ten to twenty minims thrown 
into the sac of a hydrocele 
are used by Dr. R. J. Levis.] 



Action. 

Therapeutical. 

It is therefore much used 
as an antiseptic and deodo- 
rant for the treatment of ill- 
smelling drains, etc., or to de- 
stroy the infectious properties 
of various secretions or dis- 
charges from the sick. It 
may also be useful as a lotion 
or injection to foul sores. Its 
principal application, how- 
ever, in surgery, is in enabling 
us to carry out the far-famed 
antiseptic system of Prof. 
Lister. This eminent sur- 
geon, adopting the views of 
Pasteur, and believing that 
suppuration, pyaemia, and 
various other inconveniences 
connected with open wounds, 
arise from the irritation of 
minute germs or particles of 
organic matter contained in 
the air, has devised a process 
in which the atmospheric air, 
before reaching the raw sur- 



bolic acid and thus deprived 
of its irritating properties. 

We extract from Mr. Cheyne's excellent book on antisep- 
tic surgery the following clear and condensed description of 
the way in which Lister's method is applied — " Take as an 
example of an operation the removal of a fatty tumor : 

" The patient having been brought under the influence of 
chloroform, or other anaesthetic, the skin over the tumor, 
and for some distance in the vicinity, is thoroughly purified 
from any active dust by washing it well with a solution of 
carbolic acid 1-20. The surgeon and his assistants also 
well wash their hands in 1-40 carbolic solution, while the 
10 



110 CARBOLIC ACID. 

instruments are put to soak in 1-20 ; a towel is arranged 
close to the tumor, generally on the part of the table be- 
tween the operator and the patient, which towel has been 
well soaked in 1-20 carbolic lotion, and is meant as an an- 
tiseptic basis on which instruments may be laid during the 
course of the operation without any fear of their contamina- 
tion. This towel is so arranged as to be within the cloud of 
spray. A spray being now made to play over the part from 
a convenient distance, the surgeon makes his incisions, re- 
moves the tumor, ties the vessels with catgut, introduces a 
suitable drain, stitches up the wound, and applies a piece of 
protective lint, little larger than the wound, the protective 
being of course dipped in the 1-40 carbolic solution ; outside 
this is applied a piece of wet gauze, consisting of several 
layers of loose gauze, which has been soaking for some time 
in the 1-40 carbolic solution. This wet gauze and protec- 
tive are called the deep dressing. The wet gauze must over- 
lap the protective in all directions. Then any remaining 
hollow is filled up with loose gauze, and outside the whole a 
gauze dressing is fixed. This dressing consists of a piece of 
carbolic gauze of suitable size, folded in eight layers, and 
having the macintosh placed beneath the outermost layer, 
with the India-rubber side inwards. The dressing is fixed 
by means of a bandage, and when this is accomplished the 
spray may be stopped. Then around the edge of the dress- 
ing an elastic bandage is applied so as to keep the edge con- 
stantly in contact with the body, and to allow no interval to 
occur between the dressing and the skin during the move- 
ments of the patient. The elastic is carefully fixed to the 
edge of the dressing by means of safety-pins. In the after 
progress of the case the dressing is changed according to the 
amount of discharge, though in no instance is it left longer 
than eight days." [Many surgeons have discarded carbolic 
acid in favor of mercuric chloride solutions, 1-2000 for 
wound dressing, and the spray is almost obsolete.] 

Physiological Effects. Therapeutical. 

Carbolic acid is an irri- Although carbolic acid may 

fating substance, and, if ap- be of use in correcting fetor, 

plied sufficiently long to the it is too irritating to make a 

skin, will cause sloughing. good lotion for wounds or 

It has, however, undoubted ulcers, 
anaesthetic properties. 



CARBOLIC ACID. 



Ill 



It is also readily absorbed 
through the skin, [and Con- 
tinental observers describe 
dangerous results, as fre- 
quently following its use in 
antiseptic surgery. These, 
however, are rarely, if ever, 
met with in British practice, 
Mr. Cheyne telling us that 
serious symptoms have only 
twice occurred in Prof. Lis- 
ter's practice. This he as- 
cribes to the fact that the acid 
is brought as little as possible 
in contact with wounds.] 



It has been used as a caus- 
tic in some ulcerative affec- 
tions, as lupus. It has been 
recommended as a local an- 
aesthetic during small ope- 
rations, and to deaden the 
pain of some caustic applica- 
tions. [The pain of opening 
a felon may be greatly re- 
duced by previously immer- 
sing the linger for a few 
minutes in a 3 to 5 per cent, 
solution of carbolic acid.] 

A good application in tinea 
tonsurans is : — 

Sulphuris precipitat., 
Zinci oxidi aa ^j ; or 41 Gin. 
Olei oliva? %} ; 32j 

Acid carbolici gr. xvj 1J06 " 

We must therefore remem- 
ber that symptoms of poison- 
ing may readily be produced 
by the application of carbolic 
acid over any considerable 
cutaneous area. The inhala- 
tion of carbolic acid, its local 
application by spray, or the 
diffusion of a 20 per cent, 
solution in a spray through 
the room has proved very 
useful in whooping cough ; 
and the bacillary theory of 
phthisis naturally suggests 
the destruction of the active 
agents in producing the dis- 
ease by this or some other 
form of antiseptic inhalation. 
For which cases, Dr. R. J. 
Lee has invented a very con- 
venient form of inhaler. 



112 



CARBOLIC ACID. 



Internal Action. 



Carbolic acid, if adminis- 
tered in sufficient quantity, is 
very poisonous in its opera- 
tion, killing by causing pa- 
ralysis of the respiratory cen- 
tre. The heart continues to 
beat even after the respiration 
is arrested and the tempera- 
ture falls. In severe cases we 
find collapse with stertorous 
breathing, great pallor, and 
sudden death from respiratory 
failure ; whilst a milder at- 
tack is characterized by loss of 
appetite, nausea, and vomit- 
ing, a large secretion of frothy 
saliva, dysphagia, anxiety, 
and fever. The urine is di- 
minished in quantity, and on 
standing acquires an olive- 
srreen color. 



Carbolic acid has occasion 
ally caused death by being 
accidentally drunk in mistake 
for beer, or by being incau- 
tiously applied to the skin. 
The best antidotes are olive 
oil and saccharated lime ; 
also, sulphate of sodium, in 
doses of a tablespoonful every 
half hour, of a solution con- 
taining five parts in from one 
to two hundred parts of water, 
the antidote being held to 
convert the carbolic into non- 
poisonous phenol. The sub- 
cutaneous injection of sul- 
phate of atropine has been 
advised, and also of ether 
and camphor. 

It is occasionally given in- 
ternally to counteract flatu- 
lence and sarcinous vomiting ; 
but the sulpho-carbolates, and 
more especially that of so- 
dium, are the most convenient 
forms for its administration 
in doses of 15 to 30 grains. 
[Carbolic acid has been re- 
commended for tcenia, in pill 
form, taking three to five 
grains in the course of the 
day.] 



Absorption and Mode of Elimination. 

Carbolic acid is rapidly absorbed, and quickly and en- 
tirely given off by the urine, to which it imparts a peculiar 
greenish-black hue and its own peculiar smell. [This may 
also occur as a result of absorption of carbolic acid from the 
dressings after a surgical operation.] 



CITRIC ACID. 113 



[ACIDUM CHROMICUM— CHROMIC ACID 

(Cr0 3 ; 100.4). 

Small, crimson, needle-shaped crystals, deliquescent, very soluble in water, 
decomposes with alcohol, sometimes explosively. 

Effects and Uses. 

Chromic acid is an eseharotic and antiseptic ; it rapidly 
oxidizes organic matter and is the most energetic disin- 
fectant known. A strong solution (gr. c. to f^j) may be 
applied with a glass rod to destroy warts, condylomata, and 
excrescences, or to reduce enlarged tonsils. Greatly diluted 
(gr. ss to f^j) it forms a detergent wash for mercurial 
stomatitis, scurvy, diphtheria, osdema of the glottis, ulcers, 
and p ha gedcena. On account of the difficulty of limiting its 
effect it should not be applied in substance, as, when used in 
this manner to destroy warts on the fingers, it has been 
known to penetrate and destroy the joint.] 



[ACIDUM CITRICUM—CITRIC ACID 

(H 3 C 6 H 5 O r H 2 O;210). 

Colorless prisms soluble in three-fourths part of water. 

Officinal Preparations, U. S. • 

Syrupus Acidii Citriei (8 parts in 1000). Used as 
a vehicle. 

Liquor Ferri Citratis, Liquor Magnesii Citratis, Liquor 
Potassii Citratis, Lithii Citras, Potassii Citras, and in pre- 
paring Ferri Pyrophosphas. 

Dose, gr. x-xxx (= .65 to 2 Gms.). 

Effects and Uses. 

As a refrigerant in fevers, citric acid solution is used in 
the form of lemonade, neutral mixture (liquor potassii citra- 
tis), or the citrates. It has been used in scurvy, liver disease, 
and rheumatism, and as an application to the throat in diph- 
theria (gr. viiss to fjj). Dr. H. Bence Jones believes that 
lemon juice and citric acid increase the acidity of the urine ; 

10* 



114 DILUTE HYDROBROMIC ACID. 

they consequently are contra-indicated in lithuria, and 
should not be given for a length of time, continuously, in 
the gouty diathesis.] 

External Use. 

Citric acid was proposed a few years ago as a soothing 
local application to cancerous sores, but of this little has re- 
cently been heard. 

Internal Use. 

Citric acid is used chiefly as a cheap and convenient sub- 
stitute for lemon juice in effervescing draughts, which are 
very extensively prescribed on account of their cooling and 
refreshing properties in feverish conditions, and for the 
soothing influence of their carbonic acid when the stomach 
is irritable. 

Whenever lemon juice can be procured, it should be used 
in preference ; but at periods of the year when this fruit is 
out of season, citric acid will act well, and we here give a 
table from Squire, showing the proportions in which the acid 
and alkali should be prescribed to insure exact saturation. 

17 grs. (1.12 *] f 25 grs. (1.6 gm.) bicarbonate of potassium, 

gm.) of citric .-,■. | 20 " (1.3 ") carbonate of potassium, 

acid, or half j 20 " (1.3 " ) bicarbonate of sodium. 

p- 11 Gil- "S 

a fluidounce j , ,. j 35 " (2.3 " ) carbonate of sodium, 
of fresh lem- | 15 " (1. ") carbonate of ammonium, 

on juice j ^ 13 " ( .78 ") carbonate of magnesium. 



ACIDUM HYDROBROMICUM DILUTUM— 
DILUTE HYDROBROMIC ACID. 

[A clear, colorless liquid containing ten per cent, of absolute Hydrobromic 
Acid. Dose, f5j-%] (4 to 32 Gm.). ] 

This is an excellent addition to a quinine mixture, be- 
cause it not only dissolves the alkaloid, but prevents in some 
degree the unpleasant deafness and ringing in the ears which 
often follow its administration. [It has also been used as a 
substitute for the bromides in congestive headache, insomnia, 
tinnitus aurium, etc. Two fluid drachms containing twelve 
grains of bromine are equivalent to eighteen grains of potas- 
sium bromide.] 



HYDROCHLORIC ACID. 115 



ACIDUM HYDROCHLORICUM— HYDROCHLORIC 
ACID. (MURIATIC ACID, Ph. 1870.) 

[A liquid composed of 31.9 per cent, of absolute hydrochloric acid and 
68.1 per cent, water, U. S. P. Dose, TT\J-x (.06 to .60 Gnu). 

Acidum Hydrochloricum Dilutum (Hydrochloric 
acid 6 parts, distilled water 13 parts). Dose, n^x-xl (.60 
to 2.60 Gm.). 

Enters into the preparation of Acidum Hydrocyanicum 
Dilutum "(extemporaneous), Antimonii Oxidum, Calcii 
Phosphas Precipitatus, Carbo Animalis Purificatus, Quinince 
Sulphas, Strychnina, Sulphur Prrecipitatum, and Acidum 
Nitrohydrochloricum, Aqua Clilori, Barii Chloridum, Ferri 
Chloridum, Liquor Acidi Arseniosi, Liquor Calcii Chloridi, 
Liquor Ferri Chloridi, Liquor Zinci Chloridi, Morphinre 
Murias, and Resina Podophylli. 

Poisoning. 

Hydrochloric acid is a corrosive mineral poison. It causes 
a burning pain in the pharynx and epigastrium, strong styp- 
tic, acid taste in the mouth, much thirst, tense and frequent 
pulse, dry and hot skin, red glazed tongue, lips black. There 
is vomiting of blood and yellow matter, having the odor of 
the acid. Some of the vomit falling on a marble table 
causes foaming, from escape of carbonic acid gas. Cold 
sweats, delirium, and collapse terminate life. After death 
the parts in contact with the acid are stained and highly 
inflamed, and may be eroded. The vapor of ammonia pro- 
duces a characteristic white cloud of ammonium chloride. 
Nitrate of silver throws down a white precipitate, which 
afterwards becomes black. Only the presence of a large 
excess of free acid can establish the proof of poisoning by it. 

Antidotes. 

The same as for the other mineral acids ; the alkalies and 
their carbonates ; magnesia, soap, and bland drinks may be 
freely given. Muriatic acid stains the mouth and lips black, 
when taken undiluted.] 



316 HYDROCHLORIC ACID. 



External Use. 

Hydrochloric acid is a good form of* application to diph- 
theria, when it is used combined with equal parts of honey. 

Internal Use. 

Of all the acids used in medicine, this has undoubtedly 
the most beneficial action in dyspepsia, on account probably 
of its forming one of the normal constituents of the gastric 
juice. In cases where we suspect the formation of an exces- 
sive quantity of this fluid, we may, on the principles already 
enunciated, limit its secretion by prescribing the acid imme- 
diately before meals. When the epigastric pain comes on 
immediately after eating, the condition is no doubt due to 
an irritable or perhaps ulcerated condition of the stomach 
itself, and we may best hope for success by carefully regu- 
lated diet and the use of bismuth, soda, or hydrocyanic acid. 
But when the pain does not set in with severity until from an 
hour to a couple of hours after food has been swallowed, the 
explanation probably is that an abnormal excess of gastric 
juice has been secreted, and a recurrence of this will best be 
checked by giving a little of the acid before meals. 

Hydrochloric acid has also been much recommended by Dr. 
Chambers and others in typhoid fever, and it will generally 
be found that 20-minim doses of the dilute acid are very 
grateful to the patient, as quenching the thirst and moisten- 
ing the tongue. 

In dyspepsia tti,xx ad xxx (1.30 to 2 Gm.). In typhoid 
fever ni^xx (1.30 Gm.) of the dilute acid every two hours. 

30 Gm. 



f£. Acidi liydrochlor. dil. 
Sp. chloroformi 
Infusi gentianse 
M. S. Ter in die. 

In dyspepsia. 


nixx; 
nixv 


or 1 
" ] 
" 32 



[ACIDUM GALLICUM— GALLIC ACID. 
See Galla.] 



DILUTE HYDROCYANIC ACID. 117 



ACIDUM HYDROCYANICUM DILUTUM— DILUTE 
HYDROCYANIC ACID (PRUSSIC ACID). 

[A liquid composed of 2 per cent, of absolute hydrocyanic acid and 98 per 
cent, of alcohol and water, U. S. P. 

Officinal Prepaeations, U. S. 

Potassii Cyanidum, gr. t l to T ^ (.005 Gm.). 

Poisoning. 

Prussic acid and the cyanide of potassium, in sufficient 
doses, are almost immediately fatal, so that in most cases no 
symptoms, except sudden collapse and death, are present. 
(For a more detailed account of the effects, see page 120.) 

Antidotes. 

Chlorine or ammonia may be cautiously inhaled, accom- 
panied by cold affusions to the spine, and artificial respira- 
tion. As a chemical antidote, sulphate of iron (gr. x), and 
tincture of the chloride of iron (f3j)» dissolved in a fluid 
ounce of water, may be given immediately, to be followed 
by twenty grains of carbonate of potassium, likewise in solu- 
tion, forming with the poison insoluble Prussian blue. Atro- 
pine is stated to be a physiological antidote. 

Tests. 

The peculiar bitter almond odor. A physiological test 
can be made by injecting some of the suspected fluid, hypo- 
dermically, into a rabbit, and observing its effects. When 
a little potassa is mixed with liquids containing this poison, 
and solution of the sulphate or sesquichloride of iron added, 
a grayish-green precipitate is thrown down — which deepens 
to a Prussian-blue tint on addition of a few drops of sulphuric 
acid. The nitrate of silver produces a white (cyanide of 
silver) precipitate ; which, after being washed and dried, and 
then held on a watch-glass over a flame, burns with a fresh 
rose-color, cyanogen being at the same time evolved. 

Sulphur Test. — Place two drops of a solution of hydrosul- 
phate of ammonia, containing an excess of sulphur, in the 



118 



DILUTE HYDROCYANIC ACID. 



centre of a watch-glass, and invert it accurately over the 
vessel containing the poisoned liquid. Remove the glass in 
three or four minutes, and dry the moistened spot gently 
over a spirit-lamp. Let a drop of water fall on the white 
film, and then a drop of the perchloride of iron. If prussic 
acid be present, a blood-red solution (sulpho-cyanide of iron) 
is produced; and this red color is discharged by the addition 
of one or two drops of a solution of corrosive sublimate. 

When a mixture is to be examined, containing matters 
from the stomach, etc., if alkaline, it must first be neutralized 
by addition of sulphuric acid, then one-eighth part cautiously 
distilled therefrom into a receiver immersed in some frigorific 
mixture ; and the product may then be tested by nitrate of 
silver, etc., as above.] 



Action. 

Therapeutical. 

It is therefore used exter- 
nally, largely diluted, to re- 
lieve ?ieura/gic pain and allay 
itching, more especially in 
skin disease. We may thus 
hope to alleviate the torment- 
ing irritation often attending 
prurigo and eczema; but we 
must be careful never to let 
the lotion come in contact 
with any abrasion on the sur- 
face, as prussic acid is very 
readily and rapidly absorbed. 

Internal Action. 

Hydrocyanic acid, being the most powerful and speedy 
poison with which we are acquainted, requires to be pre- 
scribed with very great caution. 



External 

Physiological. 

Prussic acid applied to the 
skin in a concentrated form 
may cause at first slight irri- 
tation, but secondarily dimin- 
ishes its sensibility, acting in 
some degree as an anaesthetic, 
probably from a benumbing 
influence on the extremities 
of the sensory nerves. 



Physiological. 

1. On the Nervous System. 
— Prussic acid has some ef- 
fect on the brain, causing 
giddiness and slight stupor ; 
the respiratory centre in the 



Therapeutical. 

1. It is used with great 
benefit in those forms of dys- 
pepsia attended with epigas- 
tric pain and vomiting fol- 
lowing food, and whether 



DILUTE HYDROCYANIC ACID. 



119 



medulla next becomes weak- 
ened, and the motor nerves 
are more or less paralyzed, 
causing excessive muscular 
feebleness. 



2. The respiration be- 
comes slow and irregular, 
and finally ceases : death in 
cases of poisoning being 
generally due to suffocation. 
The sensory nerves are also 
enfeebled in their conducting 
power. 

3. Prussic acid has a pow- 
erful sedative action on the 
heart, the circulation becom- 
ing slow, feeble, and irregular 
under the influence of poison- 
ous doses ; and this arises 
both from an influence on the 
nerves and on the muscular 
structures of the heart itself. 

It also acts directly on the 
blood, combining with the 
haemoglobin of the red cor- 
puscles, and preventing them 
from properly fulfilling their 
duty of carrying oxygen to 
the tissues. 

4. Prussic acid has no 
special influence on the tem- 
perature or on secretion, save 
that the saliva is generally 
increased in quantity. 



depending on gastric ulcer, 
or on mere irritation of the 
mucous membrane. It has 
also been given in whooping- 
cough ; but in my experience 
its action is here very uncer- 
tain, and I have been unable 
to satisfy myself that it is a 
remedy of much value. In 
some forms of chronic and 
spasmodic cough it does good, 
but it is essentially in dys- 
pepsia that we obtain real 
advantage from its use. 



3. It has been successfully 
employed in nervous palpi- 
tation [or irritable heart.] 



120 



DILUTE HYDROCYANIC ACID. 



Prussic acid is very rapidly eliminated from the system, 
probably by the breath, and half an hour may be sufficient 
for this purpose, so that in a case of poisoning we may have 
good hopes of recovery, if we can sustain the powers of life 
during this period. 



Poisonous Effects. — In a 
large dose prussic acid kills 
immediately, the victim fre- 
quently uttering a loud cry, 
and expiring from cardiac 
syncope. If the quantity 
taken be smaller, symptoms 
of suffocation supervene from 
paralysis of the respiratory 
centre, and, if the process of 
poisoning be more gradual, 
from deficient supply of oxy- 
gen in the blood ; other symp- 
toms noted being convulsions, 
great muscular prostration, 
dilatation of pupils, and quick, 
feeble, irregular pulse. Post- 
mortem examination shows 
nothing characteristic. 

If the poison be taken in 
a concentrated form, death 
may ensue very rapidly, in 
probably less than a minute. 
Preyer, who has devoted spe- 
cial attention to the subject, 
observed a guinea-pig appa- 
rently dead one second after 
inhaling some gaseous acid, 
efforts at breathing ceasing in 
fifteen seconds. He, there- 
fore, considers this the most 
deadly mode of its adminis- 
tration ; but no matter how 
it enters the body, it speedily 
kills any animal, and, curi- 
ously enough, it is equally 
destructive to plants. 



Treatment Considering 

the great rapidity of the ac- 
tion of hydrocyanic acid, it 
is comparatively seldom that 
we have any opportunity of 
employing antidotes ; but sup- 
posing we see a case suffi- 
ciently early to do so, we 
should have vigorous recourse 
to cold affusion and the in- 
halation of ammonia and 
chlorine water. Artificial 
respiration should be then 
steadily persisted in, and if 
we can thus counteract the 
tendency to death by suffo- 
cation, and tide the patient 
over the first half-hour, we 
may look forward to success, 
never despairing as long as 
the faintest pulsation can be 
felt in the heart. Secondary 
auxiliary means exist in the 
internal administration of am- 
monia, of chlorine water, or 
of carbonate of potash, fol- 
lowed by the mixed sulphates 
of iron, which convert the 
poison into Prussian blue ; 
and recently the subcutane- 
ous injection of atropine has 
been proposed as the true 
physiological antidote. 



DILUTE HYDROCYANIC ACID. 121 

Dose and Mode of Administration. 

One grain of anhydrous acid has caused death, and of this 
the preparation used in medicine contains 2 per cent, (the 
old JScheele's, which is now obsolete, having contained 4 per 
cent.). 

In consideration of the rapid way in which the acid is 
thrown out of the system, we must repeat the dose fre- 
quently, from every hour to every three hours ; and it is 
well not to order too large a quantity at one time, not be- 
cause the acid tends to float on the top, as was formerly sup- 
posed, but because there is always a chance of an overdose 
being given through ignorance or carelessness. We may 
Safely prescribe from 2 to 6 minims, beginning always with 
rr^ j, suspending it if the patient complains of any constric- 
tion about the throat. For external use f3ij may be dis- 
solved in 8 ounces of water or rose-water. 

1$.. Acidi hydrocyanici diluti f5ij ; or 8Gm. 

Glycerin i ffj ; " 32 " 

Aquae rosse q. s. ad f ^viij ; " 256 " 

Misce, fiat lotio. 

S. To be applied with a soft sponge. 

In a case of troublesome itching. 

I£. Acidi hydrocyanici diluti "Nlxij ; or 175 Grtn. 

Misturse amygdala? f §vj ; " 192! " 

Misce, fiat mistura. Capiat cochlearia magna duo tussi ad- 
modum ingravescente. 



For a case of irritable cough 



Gra. 



R.. Acidi hydrocyanici diluti "ni xxv ; or 1 

Bismuthi subnitratis ^ss ; " 2 " 

Syrupi aurantii f §j ; " 32 " 

Infusi gentian ae q. s. ad f Sjviij ; " 256 " 

Misce. Capiat cochlearia magna duo ter in die ante cibum. 

In a case of irritative dyspepsia. 

Or, a few drops of prussic acid may be added to the ordi. 
nary effervescing draught with good effect. 
11 



122 NITRIC ACID. 



[ACIDUM LACT1CUM— LACTIC ACID. 

A liquid composed of 75 per cent, absolute lactic acid, and 25 per cent, of 

water. 

Officinal Preparations, U. S. 

Syrupus Calcii Laetophosphatis (Precip. Phos- 
phate of Calcium 22, Lactic Acid 33 in 1000). Dose, 3j-3'j 
(4-8 C). 

Ferri Lactas. Dose, gr. v. (.30 Gm.) 

A syrupy, nearly transparent liquid, with slight odor and 
a very sour taste, obtained from sour milk. It has been 
found in the gastric juice, and may prove a useful addition 
to preparations of pepsin. It has been given in dyspepsia 
(dose f'5j)» m sweetened water at meal-time. Locally it has 
been employed (diluted four-fifths) as an application to the 
false membrane in croup and diphtheria. 

According to Prout, rheumatism is connected with an ex- 
cess of lactic acid in the blood ; and this would explain the 
benefit derived from the alkaline treatment.] 



ACIDUM NITRICUM— NITRIC ACID. 

[J. liquid composed of 69.4 per cent, of absolute nitric acid and 30.6 per 
cent, of water. 

Aeidum Nitricum Dilutum, 10 per ct. absolute 
nitric acid (acid 1 to water 6 parts). Dose, tt^xv-xI 
(1-2.60 Gm.). 

Also enters into Aeidum Nitro-hydrochloricum, Aeidum 
Nitro-hydrochloricum Dilutum, Argenti Nitras, Bismuthi 
Subnitras, Liquor Ferri Nitratis, Liquor Hydrargyri Nitra- 
tis, Spiritus JEtheris Nitrosi, Unguentum Hydrargyri Ni- 
tratis, and in the preparation of Aeidum Phosphoricum 
Dilutum, Antimonii Oxidum, Bismuthi Subcarbonas, Cadmii 
Sulphas, Hydrargyri Oxidum Rubrum, Liquor Ferri Chlo- 
ridi, Liquor Ferri Subsulphatis, Liquor Ferri Tersulphatis, 
Liquor Zinci Chloridi, and Pyroxylon. 



NITRIC ACID. 123 



Antidotes. 

The symptoms are those of a violent irritant and corrosive 
poison. Treatment must be prompt, by alkalies, demulcents, 
and in short the same method is followed as in poisoning by 
the other mineral acids. Nitric acid stains the skin yellow.] 

External Use. 

Nitric acid is undoubtedly the best form of local applica- 
tion in all forms of sloughing or phagedenic ulceration, 
whether of venereal origin or otherwise. In these rapidly 
destructive forms of disease, we shall do well to place our 
patient under the influence of an anaesthetic, and then apply 
the strong acid freely and thoroughly to all parts of the 
affected surface, and we shall thus often succeed in arresting 
a process which would otherwise go on to severe and even 
fatal disorganization. 

It is also used locally in the treatment of piles, more 
especially those flat irritable forms of tumor which do not 
come readily within the reach of the clamp or ligature. 

In the proportion of 10 or 20 minims to an ounce, nitric 
acid forms a good astringent lolion in cases of indolent or 
unhealthy sores : and it has been recommended by Dr. 
Roberts, of Manchester, as an injection into the bladder for 
the solution of phosphatic calculi. 

Internal Use. 

Given internally, nitric acid has tonic properties, and, in 
combination with bark and opium, acts well in cases of foul 
or sloughing ulceration. Again, in constitutions broken 
down by syphilis or by chronic hepatic disease, we may very 
beneficially give our patient from 15 to 20 minims of the 
dilute acid three times a day, its action on the liver beinjj by 
some supposed to have somewhat of a specific character. 

I£. Acidi nitrici diluti f^ij ; or 8 Grm. 

Tincturae opii ir^xl ; " 2 60 " 

Tincturse cinchonse f§ss ; " 16 " 

Decocti cinchonse ad f§viij ; " 256 " 

Misce. Capiat cochlearia magna duo ter in die. 

In the case of foul or slouching ulcer. 



124 PHOSPHORIC ACID. 

ACIDUM NITRO-HYDROCHLORICUM— NITRO- 
HYDROCHLORIC ACID. 

Nitric acid A parts, hydrochloric acid 15 parts. 
[Dose, n^ij-v (.13 to 30. Gm.). 
Acidum Nitro-hydroehloricum Dilutum. 

Nitric acid, 4 parts, hydrochloric acid 15 parts, distilled icater 76 parts. 
Dose, tt^v-xx (.30 to 1.JJ0 Gm.).] 

This is supposed to have some special action on the liver, 
and is most extensively used in chronic functional affections 
of that organ. It has also been highly recommended, in the 
form of bath, in various hepatic disorders in the proportion 
of six fluidounces to each gallon of water. Or, internally — 

I£. Acidi nitro-hydroclilor. diluti f£ij ; 8 

Extract, taraxaci i^ss ; 10 

Spiritus chloroformi t5' ss '■> 6 

Aqua? q. s. ad f| viij ; 256 

M. S. Capiat oochlearia magna duo ter in die. 

In a case of sluggish liver. 



Gm. 



ACIDUM OLE1CUM— OLEIC ACID. 

[A yellowish, oily, liquid, gradually becoming broivn, rancid, and acid, 
when exposed to the air. Insoluble in water. Equal volumes of the 
acid and of alcohol heutul to 71° F. should give a clear solution, without 
separating oily drops upon the surface. 

The officinal Oleates are — Oleatum Hydrargyri, 
Oleatum Veratrinae.] 

This is used in the manufacture of the oleates of mercury, 
lead, zinc [and of some of the alkaloids such as Morphine, 
Atropine, Veratrine, Aconitine, etc.], which are clean and 
handy preparations. 



ACIDUM PHOSPHORICUM— PHOSPHORIC ACID. 

[A colorless, odorless liquid containing 50 per cent, of orthophosphoric 
acid. 

Dose rr^iij to viij (.20 to .50 Gm.). 

Acidum Phosphorieum Dilutum. (Contains 10 
per cent. Orthophosphoric Acid.) Dose, n^xv-xlj (1. to 
2.00 Gm.).] 



SALICYLIC ACID. 125 

The officinal phosphates are — Ammonii Phosphas ; Ferri 
Phosphas, and Sodii Phosphas. 

The officinal hypophosphites are — Calcii Hypophosphis ; 
Ferri Hypophosphis ; Potassii Hypophosphis ; Sodii Hypo- 
phosphis. 

This acid has been credited with various special therapeu- 
tical virtues none of which have stood the test of experience, 
and it is now merely used as a light and agreeable tonic and 
astringent. We take occasion, however, to mention a mis- 
take which is not uncommonly made in prescribing, and that 
is to prescribe phosphoric acid with the view of obtaining 
the medical influence of phosphorus. Now it is well known 
that only from phosphorus in a free condition do we obtain 
any real benefit, and of this phosphoric acid contains no 
trace. 

[It has, however, been used as a tonic and alterative in 
rickets and scrofula ; and is an excellent adjuvant to cough- 
mixtures, or tonics, for elderly patients.] 



ACIDUM SALICYLICUM—SALICYLIC ACID. 

[Fine, white, needle-shaped crystals, sol. in 450 parts cold or 14 parte 
hot water. 

The officinal salicylates are : — 

Sodii Salicylas. Dose, gr. x to 3j (.65 to 4 Gm.). 
Lithii Salicylas. Dose, gr. x to 5j (.65 to 4 Gm.). 
Physostigminae Salicylas. Dose, gr. ^-^V (- 001 
to .01 Gm.).] 

Local Actions. 
Physiological. Therapeutical. 

Salicylic acid is an excel- Being less irritant than 

lent antiseptic, delaying pu- carbolic acid, it has been pro- 

trefaction and preventing de- posed as a substitute for that 

composition, but in this re- substance in carrying ou£ 

spect it is decidedly inferior Lister's antiseptic system, ji 

to carbolic acid. has also been recommended 

Maclagan, regarding acute as a good lotion to raw sur- 

rheumatism as of malarial faces ; but Callender has 

origin, holds that salicylic shown that it not only tends 

acid acts by destroying the to irritate the wounds, but 

poison on which the disease frequently brings out a crop 

11* 



126 



SALICYLIC ACID. 



depends, and which, if the 
theory be true, is probably 
some form of microbe. 



of irritable vesicles in their 
neighborhood, attended with 
marked constitutional distur- 
bance. [It has been used as 
an application in croup, diph- 
theria, and hay-fever, in pow- 
der or solution.] In anti- 
septic surgery salicylic wool 
and jute are of considerable 
service. 



Constitutional Action. 



Salicylic acid is an antisep- 
tic and antipyretic, rapidly 
reducing temperature in fe- 
verish conditions, although, 
in a state of health, the drug 
seems to be without influence 
on the body heat. Some 
headache, giddiness, and ring- 
ing in the ears have been 
observed, but the cardiac and 
respiratory functions are not 
sensibly affected. 

In poisonous doses, slowing 
of the breathing and convul- 
sive attacks, from diminution 
of the excitability of the 
vagus, have been observed. 
Nausea, burning in the throat, 
vomiting, and stomach irrita- 
tion have occasionally been 
noticed to follow the use of 
the acid ; and albuminuria 
with almost total suppression 
of urine, and occasionally 
hematuria are more rarely 
noted among its effects; the 
most usual action, however, 
on the kidneys being diuretic, 
with slight increase of urea 
and uric acid. 



Salicylic acid is now uni- 
versally allowed to be a most 
efficient remedy in acute 
rheumatism, very rapidly re- 
ducing temperature, relieving 
pain, and, in fact, cutting 
short the disease. By short- 
ening the duration of the 
joint inflammation, it natu- 
rally limits the tendency to 
cardiac complications; but it 
seems to have no power of 
directly reducing the liability 
to this accident, nor influence 
over developed pericarditis, 
or in averting or arresting 
conditions of hyperpyrexia. 
In an ordinary case of acute 
articular rheumatism, we may 
count upon cutting short the 
disease in two of three days, 
the pain going first and then 
the fever. It is well to con- 
tinue the drug for 10 or 15 
days after the apparent cure, 
in order to prevent relapses, 
and the anaemia so often fol- 
lowing other modes of treat- 
ment is not met with under 
this. It is of less service in 



SALICYLIC ACID. 127 

chronic rheumatism or gout ; 
it is useless in ague, and, al- 
though in typhoid fever the 
temperature may go down, 
no influence is exerted on 
the duration of the disease. 

Mode of Elimination. 

Elimination is effected by the urine, beginning in 10 
minutes and being completed in from 24 to 48 hours, and 
the acid seizing glycocol from the liver and other organs, 
becomes converted into salicyluric acid, thus resembling the 
conversion of benzoic into hippuric acid. Probably a little 
is also given off by the sweat and saliva. The soda salt is 
rapidly transformed into the original acid by the carbonic acid 
of the blood. 

Dose and Mode of Administration. 

We may give salicylic acid in 20-grain doses, repeated 
hourly for six hours on two successive days and continued at 
shorter intervals if the disease resists 48 hours' medication. 
As much as 280 grains have been given without injury 
within 12 hours, but it is always well to avoid very large 
doses, which are very apt to cause irritation and discomfort. 

Salicylic acid, being irritating and very insoluble, has been 
now almost entirely displaced by the salicylate of soda, which 
is freely miscible with water and is readily absorbed ; the 
dose being gr. xx to 5j (1-30 to 4 Gm.), being generally 
administered in the smaller dose every hour until a drachm 
has been given daily. 

Dangers from Salicylic Acid. 

[Several instances have occurred in which this agent has 
unexpectedly produced disagreeable consequences. Dr. 
Watelet communicated a paper to a late number of the 
Bull, de Therapie on this subject, in which the details are 
given of two cases of rheumatism treated by salicylate of 
soda, one of which was followed by gangrene of the lower 
extremities, and both by cystitis, obstinate constipation, and 
coldness of the extremities. 1 

1 Dublin Press and Circular. 



128 



SALICYLIC ACID. 



Salicylic acid has a strong affinity for lime, and it is 
thought that its administration, it" long continued, may inju- 
riously affect the bones and the teeth. Whether this tech- 
nical objection also exists against it when given in combina- 
tion with alkalies, is not clear, but in this form it is certainly 
safer, and these salts are now generally used in preference to 
the acid itself.] 

Since these alkaline salts have come into general use, we 
have heard much less of the uncomfortable effects occasion- 
ally caused by the acid, and some of which, at all events, 
were due to impure preparations containing carbolic or 
cresylic acid. But, in addition to the peculiarities men- 
tioned above, careful observers have described urticaria and 
irritable erythematous and vesicular, cutaneous affections 
and sore throat, with a species of quiet delirium and feverish 
symptoms, and we are specially warned to be aware of its 
use in kidney disease. As a general rule, however, the sodium 
salt may be freely prescribed without the anticipation of any 
of these undesirable results. 

Salicylic acid is very insoluble, and it is difficult to find a 
ready medium for its administration. Messrs. Savory and 
Moore have devised a very elegant granular, effervescing 
preparation, or we may use the salicylate of sodium or am- 
monium. The following are good formulas : — 



Acidi salicylici gj ; 

Olei amygdalae expressi t'3 v 5 

Pulv. acaci* 5'J sS 

Syrupi amy gd ala? t'3vj ; 

Aquae aurantii floruin q. s. ad l§iij ; 
Capiat fgj pro dosi. 



M. 



For children. 



Oi 



$. Acidi salicylici 

Alcoliolis 
Dissolve. 



3.i 5 or 

t^ijss; " 



4|G:m. 
10 " M. 



Potassii citratis 
Syrupi aurantii 
Aquae 
S. Mix the two solutions and filter 
to taste. 



f3J 

f5ij 
i3iijss 



M. 



and then dilute with water 



SULPHURIC ACID. 129 

[The following is used by Da Costa quite extensively in 
acute rheumatism : — 



I£. Sodii salicylatis gr. xx ; or 1 

Glycerini tr\,xv ; " 1 

Tinct. lavandulse comp. Tr^vijss ; " 

Aquae q. s. ad £ss ; " 16 

Fiat liaustus quartis horis sumendus.] ' 



30 Gm. 

50 " 



M. 



ACIDUM SULPHURICUM— SULPHURIC ACID. 

[A liquid composed of not less than 96 per cent, of absolute 
Sulphuric Acid (H 2 S0 4 : 98), and not more than 4 per 
cent, of water. 

A colorless, oily liquid of sp. gravity not less than 1.840. 

Preparations. 

Acidum Sulphuricum Dilutum — Dilute Sulphuric Acid (ten 
per cent, of officinal acid). Dose rr^ij— x (.12 to 2 Gm.). 

Acidum Sulphuricum Aromaticum — Aromatic Sulphuric 
Acid (about 20 per cent). Dose n^iij-xx (.20 to 1.35 Gm.). 

Also enters into the manufacture of Acidum Sulphurosum, 
Aluminii Sulphas, Atropine Sulphas, Cadmii Sulphas, Ferri 
Sulphas, Hydrargyri Sulphas Flava, Liquor Ferri Subsul- 
phatis, Liquor Ferri Tersulphatis, Oleum ^Ethereum, Quininre 
Sulphas, Acidum Hydrocyanicum Dilutum, .iEther, Argenti 
Cyanidum, Chloroform um Purificatum, Hydrargyri Chlori- 
dum Corrosivum, Hydrargyri Chloridum Mite, Hydrargyri 
Cyanidum, Pyroxylon, Sodii Phosphas, Spiritus jEtheris 
iNitrosi, and Veratrina. 

Tests. 

If in a concentrated state, any organic matter placed in 
contact with it is blackened and charred ; when mixed with 
an equal bulk of water, much heat is evolved ; when boiled 
with copper filings or mercury, sulphurous acid gas is gene- 
rated. When the acid is in a diluted state, the best test is 
nitrate of barium, which causes a dense white precipitate of 
sulphate of barium ; this can be verified by calcining it for 
some minutes with an equal weight of charcoal, wrapped in 
platina foil, then introducing the residue into a glass tube 
and adding a few drops of muriatic acid. This will liberal e 



130 SULPHURIC ACID. 

sulphuretted hydrogen, which can be recognized by its odor, 
and by its blackening carbonate or acetate of lead. 

Poisoning. 

The symptoms are those of an acrid, corrosive poison. 
They come on suddenly after taking food or medicine, and 
the patient soon becomes collapsed. Recovery is apt to be 
followed by stricture of the oesophagus. 

Antidotes. 

Alkalies should be given in milk or soapsuds, though much 
water would be improper. Care should be taken not to rup- 
ture the stomach with the tube of the stomach-pump, or by 
inducing severe efforts at vomiting. The acid, when concen- 
trated, discolors the mouth and lips, making a black slough. 
When administered medicinally it should be taken much di- 
luted, through a glass tube, in order to protect the teeth.] 

External Use. 

Strong sulphuric acid is the most powerful caustic of this 
group, rapidly charring and desiccating the tissues, from its 
great affinity for water. M. Velpeau, of Paris, strongly re- 
commended its use in cancer, the acid being made into a 
paste with saffron, and applied to the morbid growth, it 
being found, after detachment of the sloughs, that a clean 
ulcerating surface remained ; and Professor Syme proposed 
a modification of this plan, on the score of economy, by using 
sawdust instead of saffron. Ricord, of Paris, also advises the 
application of sulphuric acid in combination with charcoal 
toprimary syphilitic sores, holding that, if this process is 
effectually carried out before the fourth day, we may hope to 
avert the evil consequences of constitutional infection. 

Mr. Pollock has advised the local use of strong sulphuric 
acid in caries and necrosis and suppurating synovial mem- 
brane of joints, either applied on a glass rod, or injected, or 
brought into contact on lint with the diseased surfaces, in the 
proportion of one part of acid to two, three, or six parts of 
water ; and this plan of treatment has been used with good 
success in St. George's Hospital (vide " Lancet," May 28, 
1870, and "Medical Times and Gazette," December 11, 
1875). [Hydrochloric acid is a better solvent for dead 



SULPHUROUS ACID. 131 

bone, because the chloride of lime is more soluble than the 
sulphate.] 

Internal Use. 

Diluted sulphuric acid is a good astringent, and as such 
is extensively used in night sweats and in diarrhoea, more 
especially that which is so common in summer. It has also 
been advised in the form of lemonade, as a prophylactic 
against painters' colic, and there is no doubt that it heightens 
materially the action of purgative salts, probably by in- 
creasing their solubility. 

$. Magnesii sulphatis ^ij ; 64jGrm. 

Ferri sulphatis gr. xxiv ; 1 60 

Acidi sulphurici diluti f&ij ; 8| 

Infusi ealumbse q. s. adf^viij ; 256> 

Misce, fiat mistura. 

S. Capiat cochlearia magna duo omni mane. 

R_. Acidi sulphurici diluti f5iiss ; 10 Grm. 

Tincturse opii fgj ; 4 " 

Syrupi aurantii f§j ; 32 " 

Aquae q. s. ad ffviij ; 256 " 

M. S. Capiat unciam unam ter in die post singulas sedes 

liquidas. 

[For dysentery.] 



ACIDUM SULPHUROSUM— SULPHUROUS ACID. 

[A liquid composed of about 35 per cent, of sulphurous acid gas, and 
about 96.5 per cent, of water, U. S. An aqueous solution of sulphu- 
rous acid gas, having the odor of burning sulphur, and a sulphurous, sour, 
and somewhat astringent taste. Its specific gravity is about 1.022. 

Dose f5ss and f5ij (2. to 8. Gm.). Largely diluted with 
water.] 

External Use. 

The therapeutic properties of this acid depend in part on 
its very poisonous. influence on the lowest forms of animal 
and vegetable life. Thus it forms a good application to 
those varieties of skin disease, as tinea tonsurans, chloasma, 
etc., which depend on the presence of a minute cryptogamic 
plant ; and Dr. Dewar some years ago published a pamphlet 
in which he ascribed to this acid powers little short of mar- 



132 TANNIC ACID. 

vellous. Going on the theory that a very great number of 
diseased conditions depend on the irritation of germs, Dr. 
Dewar most confidently advised its use in affections ranging 
from rheumatic fever to chilblains. Although experience has, 
naturally, not borne out his extravagant assertions, we have 
to thank him for making known to us the undoubtedly good 
effect of sulphurous acid in various forms of sore throat, used 
in considerable dilution either as spray or gargle. It is also 
a good disinfectant, as we know that the antiseptic properties 
of sulphur, when burnt for purifying purposes, depend on its 
formation. 

Internal Use. 

Sulphurous acid has been recommended by Dr. Lawson in 
pyrosis, the dyspeptic symptoms attending which are due to 
various forms of leptothrix and vegetable growths burrowing 
in the mucous membrane of the stomach ; and in flatulence 
it is also deserving of a trial. 



[TANNIC ACID. 

Light yelloicish scales, soluble in sixteen parts cold water. 

Officinal Preparations, U. S. 

Aeidum Tannieum. Dose, gr. j-iv (.06 to .24 Gm.). 
Unguentum Aeidi Tanniei (ten per cent.). 
Troehisei Acidi Tanniei, each gr. j. Dose 1 to 5. 
Collodium Stypticum. Styptic Collodion. (Tannic 
acid, 20 ; alcohol, 5 ; stronger ether, 20 ; collodion, 55.) 

External Use. 

The test for tannic acid is albumen, gelatin, or the salts of 
iron ; with the first two it produces an insoluble precipitate, 
with the last a black color in solution. 

Tannin is incompatible with albumen, gelatin, the gluco- 
sides, and substances containing alkaloids, and with most 
metallic salts in common use. 

For medical uses, see Galla.] 



TARTARIC ACID. 133 

[ACIDUM TARTARICUM—TARTARIC ACID. 

In colorless prisms, soluble in 0.7 part cold water. 

The officinal tartrates are Antimonii et Potassii Tartras 
(Tartar Emetic), Ferri et Ammonii Tartras, Ferri et Po- 
tassii Tartras, Potassii Tartras, Potassii et Sodii Tartras 
(Rochelle Salt), Potassii Bitartras. 

Officinal Preparation. 

Pulvis Efferveseens Compositus. (Seidlitz pow- 
der.) (Each contains 35 grains tartaric acid, and 40 grains 
bicarbonate of sodium, with two drachms of Rochelle Salt.) 

(Also enters into Abstractum Aconiti and Extractum 
Aconiti.) 

Poisoning. 

Tartaric acid is a corrosive vegetable poison ; its symp- 
toms are very analogous to those caused by oxalic acid, and 
the morbid appearances likewise resemble those produced by 
oxalic acid. 

Tests. 

When heated on platina foil, it burns with a pale reddish 
flame, and exhales a peculiar acrid vapor, leaving much car- 
bonized matter. When a solution is treated with lime-water, 
it affords a white precipitate, soluble in an excess of the acid ; 
when treated with caustic potassa, it affords a granular pre- 
cipitate of the bitartrate. 

Antidotes. 

The alkalies, magnesia, lime, soap, or the alkaline car- 
bonates. 

Internal Use. 

It has been stated that tartaric acid, in .60 to 1.30 gm. (gr. 
x-xx) doses, given thrice daily will render the urine acid. 
The tartrate of magnesium has been recommended as a 
cheaper substitute for the citrate as an aperient, and is con- 
sidered quite as efficient. In sweetened solution, tartaric acid 
is sometimes used as a refrigerant drink in fevers. The tar- 
trates are laxative and diuretic] 
12 



134 ACONITE. 

[Acida. 

Lists of acids, officinal in the U. S. Pharmacopoeia : — 

Acidum Aceticum Aciduria Lacticum 

" " Dilutum " Nitricum 

" " Glaciate " Nitricum Dilutum 

" Arsenic-sum " Nitro-Hydrochloricum 

" Benzoicum " " Dilutum 

" Boricum " Oleicum 

" Carbolicum " Pliosphoricum 

" " Crudum " " Dilutum 

" Chromicum " Salicylicum 

" Citricum " Sulpliuricum 

" Gallicum " " Aromaticum 

" Hydrobromicum Dilutum " " Dilutum 

" Hydrochloricum " Sulphurosum 

" " Dilutum " Tannicum 

" Hydrocyanicum Dilutum " Tartaricum] 



ACONITUM— ACONITE. 

[ T7ie tuberous root of Aconitum Napellus (N. 0. Ranunculaceoz) . 
Dose, gr. J to ij (.03 to .13 Gm.). 

Officinal Preparations, U. S. 

Abstractum Aconiti. Dose,gr. |tol (.03 to .06' Gm.). 

Extraetum Aeoniti. Dose, gr. j to ss (.01 to .03 
Gm.). 

Extraetum Aeoniti Fluidum. n^ to ij. (.03 to 
.13 Gm.). 

Tinetura Aconiti. (40 per ct.) Dose, gtt. j-v (.06 
to .30 Gm.). 

(Fleming's tincture of aconite root contains 66f per cent.) 

Antidotes. 

Finely powdered animal charcoal, tannin, astringent in- 
fusions, and hot alcoholic stimulants are useful. The stom- 
ach should be carefully washed out, and subsequent symp- 
toms met pro re nata.~] 



ACONITE. 



135 



Poisonous Properties. 

Aconite may kill either by 
direct cardiac syncope, or, 
if the action be less rapid, by 
respiratory failure. Great 
muscular weakness is noted, 
the heart's action becoming 
feeble and irregular, the face 
pale, the body bedewed with 
clammy sweat, the pupils first 
contracted, and then dilated 
shortly before death closes 
the scene. The resemblance 
of aconite root to horse-radish 
has afforded several lamenta- 
ble opportunities of studying 
cases of accidental poisoning. 



Therapeutical. 

In poisoning by aconite, 
we must endeavor to sustain 
the flagging action of the 
heart by giving stimulants, 
and keeping the patient most 
rigidly in the recumbent pos- 
ture, as death has occurred 
from syncope produced by 
suddenly sitting up in bed. 
Digitalis has been proposed 
as the physiological antidote, 
bracing up and restoring the 
contractility of the heart 
muscle, twenty minims of 
tincture of digitalis being ad- 
ministered hypodermically. 



Local Action. 



Physiological. 

Aconite, locally applied, 
causes a sensation of tingling, 
followed by numbness of the 
skin, from a paralyzing influ- 
ence, no doubt, on the sen- 
sory nerves. It may also 
bring about some local vaso- 
motor paralysis. 



Therapeutical. 

Aconite is a most valuable 
local sedative in painful ner- 
vous affections, and more es- 
pecially in facial neuralgia, 
where the tincture or lini- 
ment applied along the course 
of the affected nerve, will 
often allay and even remove 
suffering. 



Constitutional Action. 



Physiological. 

1. On Nervous System. — 

1. Brain In poisoning by 

aconite, the intellectual facul- 
ties are usually quite unaffect- 
ed, but in some cases stupor 
has been observed. 

2. Spinal Cord.— Aconite 
paralyzes both the reflex and 



Therapeutical. 



136 



ACONITE. 



the motor activity of the cord, 
as evidenced by almost total 
loss of power in the muscular 
system. 

The respiratory centre also 
eventually becomes para- 
lyzed, and death may result 
by suffocation. 

3. Although this loss of 
voluntary movement is sup- 
posed to be primarily spinal 
in origin, it is believed that 
the motor nerves themselves 
are secondarily affected, the 
paralyzing influence begin- 
ning at their peripheral ex- 
tremities. The inhibitory 
cardiac ganglia are first stim- 
ulated, and secondly de- 
pressed, and a sedative effect 
is produced on the sensory 
nerves, the earliest indication 
of the action of the drug 
being tingling followed by 
numbness and anaesthesia of 
the lips and throat. 

Opinions differ as to the 
influence of aconite on the 
vaso-motor nerves, and it is 
not believed by many autho- 
rities to have any special ope- 
ration over this system. Dr. 
Bagshawe, however, has pub- 
lished some cases of facial 
sympathetic paralysis, with 
injection and sweating, fol- 
lowing the local application t 
of aconite, and the diaphoretic 
action, so often noted, must 
proceed from this cause. 
Experimental evidence, how- 
ever, is very conflicting in 
this, as well as in other 



3. Aconite is one of our 
best remedies in facial neu- 
ralgia, given either alone or 
in combination with quinine. 
In sick headache also it is of 
service, and here it will be 
prescribed along with tinc- 
ture of Indian hemp. 



ACONITE. 



13? 



points, respecting the physio- 
logical actions of aconite. 

II. Circulating Appara- 
tus Aconite is essentially a 

cardiac sedative, slowing the 
action of the heart at first 
from inhibitory stimulation, 
but then causing an increase 
in the rapidity of the pulsa- 
tions, with feebleness and 
irregularity, ending in death 
by arrest of all movement in 
diastole. At the same time 
the arterial pressure falls in 
very marked degree. 



12= 



II. Aconite is an excellent 
antiphlogistic, cutting short 
inflammatory processes in 
their early stages. Thus in 
pneumonia, pleurisy, peri- 
tonitis, erysipelas, rheumatic 
fever, and in the short, sharp 
feverish affections of children, 
it is of signal service, and 
seems to have a directly cura- 
tive action. Dr. John Har- 
ley (St. Thos. Hosp. Reports, 
New Series, vol. v.) made 
some interesting observations 
at the London Fever Hospital 
on the action of aconitina. 
He found that by giving ^l^ 
of a grain once a day, which 
was quite sufficient to produce 
physiological effects, no in- 
fluence was exerted on the 
course of 29 cases of scarlet 
fever, and that diaphoresis 
was only twice produced ; 
whilst in 20 cases of typhus 
but slight controlling influ- 
ence was exerted over the 
febrile process, although the 
cases did unusually well. 
This may prove either that 
the dose was not repeated 
sufficiently often, or that 
aconite has no real power 
over fully developed inflam- 
matory processes. In coryza 
and in acute tonsillitis, also, 
it has been much praised for 
the way in which it checks 
the full development of these 
troublesome affections, and it 
has been highly praised as 



138 



ACONITE. 



III. Respiration and Tem- 
perature. — The respiratory 
movements tend to become 
slow, finally irregular, and in 
some cases, and almost uni- 
versally in the lower animals, 
death results from cessation 
of breathing. 

The temperature falls de- 
cidedly. 

IV. Digestive and Secret- 
ing Apparatus — Aconite has 
no special influence on diges- 
tion. It increases somewhat 
the salivary secretion and 
augments largely the action 
of the perspiratory apparatus 
of the skin, bringing out in 
some instances an irritable 
vesicular eruption. The urine 
is also somewhat increased 
in quantity. 



given in from one-half to 
two minim doses where we 
have any reason to fear the 
occurrence of rigor, after 
catheterism. 

III. Some part of the good 
effect of aconite in these fe- 
brile affections must be due 
to its power in slowing the 
breathing and reducing the 
temperature. 



IV. [It has been given in 
the vomiting of pregnancy, 
but, like most remedies for 
this disorder, with only tem- 
porary benefit.] 



Aconite is therefore an ex- 
cellent diaphoretic, and to 
this action in some degree are 
due its antipyretic properties. 



Absorption and Mode of Elimination. 

Aconite is rapidly absorbed, and given out probably by 
the urine. The alkaloid aconitine, if accidentally blown into 
the eyes or respiratory passages, causes well-marked con- 
junctival and bronchial irritation. Prof. Gubler, of Paris, 
values it very highly in neuralgia of the fifth nerve, which 
he has never known to resist a quarter of a milligramme of the 
nitrate of aconitine, corresponding to one-half milligramme 
of the pure drug. He thinks we distrust the drug too much, 
but draws attention to a peculiar precordial disturbance, 
with palpitation and cardiac irregularity, rarely following its 
use, and warns us never to employ it in heart disease. 



ACONITE. 139 



Cautions and Modes of Administration. 

The very poisonous nature of aconite renders caution 
necessary in its use, and we must prescribe it with great 
care in old persons, or where any suspicion exists of feeble- 
ness of the heart's action. In sound constitutions, however, 
and more especially in the case of children, we may use it 
with freedom, often obtaining really extraordinary results. 

It is essential to encounter the inflammation at an early 
stage, before structural changes have set in ; and it is 
important to combine a little stimulant with the drug. In 
very acute cases, our best practice will be to give the tincture 
in small and very often repeated doses, carefully watching the 
effect on the pulse. One-fourth to one-third of a drop of the 
tincture of aconite every ten minutes, half-hour, or hour, will 
be the best arrangement during the first day, after which 
every two hours will be a sufficient interval, the thermome- 
ter giving us meanwhile reliable information regarding the 
progress of the inflammatory condition. In facial neuralgia, 
also, we shall obtain the best results by quarter drop doses 
repeated at very short intervals, and in no case is it well to 
overstep a maximum dose of 5 minims. 

The alkaloid aconitina is occasionally used as an external 
application [in ointment, containing gr. j-ij to the ounce. 
Squibb manufactures a two per cent, oleate of aconitina for 
the same purpose,] but it is not only very expensive, but 
dangerous on account of its extreme physiological activity. 

[It has lately been used in neuralgia, especially trigeminal, 
in doses of t \q to T J ¥ of a grain (.0005 Gm.). In feeble 
persons the dose to begin with should not be higher than gr. 
sis or ^J u (Seguin). Murrell has lately called attention to 
the great variation of the commercial forms of aconitine, 
which as usually supplied, is not a simple substance, but a 
mixture of several alkaloids. English aconitina is said to 
be seventeen times stronger than the German. Dangerous 
symptoms have been reported from minute doses, and it 
seems advisable for the present to employ the tincture or ex- 
tract in preference. According to C. A. Wright, aconitum 
napellus contains at least three alkaloids — crystallizable aco- 
nitine, picra-aconitine (nearly inert), and a third amorphous 
alkaloid, which largely composes the bulk of the commercial 
aconitine.] 



140 LARD— ETHER. 



ADEPS— LARD. 

[The prepared internal fat of the abdomen of Sus Scrofa, Linne* (Class 
Mammalia, Order Pachydermata) , purified by washing with water, 
melting, and straining. 

Officinal Preparations. 

Adeps Benzoinatus, benzoinated lard (2 per cent, 
benzoin). 
Oleum Adepis. 

Lard is emollient and is sometimes used in frictions, but 
is chiefly employed in Pharmacy in the preparation of oint- 
ments and cerates. In obstetrical and gynaecological prac- 
tice, lard is considered to be a universal lubricant, and is 
rarely absent from the lying-in chamber, where it is also used 
as a detergent to remove the vernix caseosa from the new- 
born. Washed lard is occasionally employed to prevent the 
eyelids from adhering in catarrhal conjunctivitis.] 



tETHER—ETHER. 

[A liquid consisting of about 74 per cent, of ethyl oxide and 26 per cent, of 
alcohol containing a little water: 

Used in preparing Acidum Tannicum, Ceratum Sabinae, 
Oleoresina Capsici, Oleoresina Cubebae, Oleoresina Filicis, 
Oleoresina Lupuliae, Oleoresina Piperis, and Tinctura Opii 
Deodorata. 

Officinal Preparations, U. S. 

j£Ether Fortior — stronger ether, a liquid composed 
of about 94 per cent, of ethyl oxide, and 6 per cent, of alco- 
hol containing a little water. (For producing anaesthesia.) 

Oleum iEthereum (aether fortior and heavy oil of 
wine equal parts), used in preparing Compound Spirits of 
Ether. 

Spiritus -ffitheris (aether fortior 30, alcohol 70. Dose, 
7itx-3i (.60 to 4. Gm.). 

Spiritus -ffitheris Compositus (aether fortior 30, 
alcohol 67, oleum aethereum 3). Dose, n^x-5 (.60 to 4. 
Gm.), Hoffmann's Anodyne. The dose is ni,x-3j (.60 to 4. 
Gm.) in cold water or syrup. 



ETHER. 



141 



-<Ether fortior is used in preparing Aconitina, Atropinne 
Sulphas, Collc-dium, Collodium cum Cantharide, Oleum 
^Ethereum, and Oleoresina Zingiberis.] 



Local 
Physiological. 

The projection on the skin 
of a very fine spray of spe- 
cially pure ether, by means 
of Dr. Richardson's ingenious 
instrument, causes at first a 
sensation of extreme cold, 
attended occasionally by the 
formation of frost. In about 
a minute, or even less, to this 
succeeds a sudden blanching 
of the service, the skin be- 
coming hard and quite in- 
sensible, and a sharp cutting 
pain, like a burn, being at the 
same time experienced. 

If the action is kept up for 
some time, redness, tingling, 
vesication, and even slough- 
ing may be produced. 

Be careful always to pro- 
cure the pure anaesthetic 
ether, which has a low boil- 
ing point, and evaporates 
rapidly, as ordinary qualities 
of the drug are of no use for 
local anaesthesia. 



Action. 

Therapeutical. 

Advantage has been taken 
of the insensibility to pain 
produced by the ether spray, 
to use it extensively during 
the performance of many 
minor operations, and more 
especially in those which 
consist merely of a single 
cut or prick. Under these 
conditions it acts admirably, 
but the hard and brawny 
state of the integument pro- 
duced by its action renders 
it of little or no aid where 
dissection or manipulations 
of deep-seated structures are 
required. Further objections 
to its use are the acute pain 
attending application, and the 
subsequent redness, tingling, 
and irritation of the skin 
[and possible sloughing]. 

It has also been recom- 
mended as a sedative in 
neuralgia, and as a con- 
venient means of applying 
intense cold ; and cases of 
its successful employment in 
chorea, applied to the upper 
part of the spine, have been 
recorded. 



Internal Actions. 



Ether, when taken inter- 
nally, is stimulant and anti- 
spasmodic. 



It is therefore a useful 
remedy in hysteria, flatu- 
lence, spasmodic asthma, etc. 



142 



ETHER. 



Combined Internal and External Use. 



Physiological. 

Ether has powerful anaes- 
thetic properties, and differs 
from chloroform in the fol- 
lowing respects : It increases 
instead of diminishing the 
arterial pressure, and acts as 
a tonic to the heart, which 
continues to pulsate in fatal 
cases after the arrest of 
breathing. The following is 
the order of involvement of 
the nerve centres : — 

1. The cerebrum. 

2. The sensory centres of 
the cord. 

3. The motor centres of 
the cord. 

4. The sensory centres of 
the medulla oblongata. 

5. The motor centres of 
the medulla. 



Therapeutical. 

The stimulant action of 
ether on the heart has caused 
its use to be warmly advo- 
cated as in all respects supe- 
rior to chloroform. It can- 
not, however, be considered 
absolutely safe, and it labors 
under several disadvantages, 
such as the greater length of 
time required to produce 
anaesthesia, the violent strug- 
gling occasionally observed, 
the disagreeable smell of the 
drug, etc. ; and the greater 
tendency to hemorrhage dur- 
ing its administration. Gubler 
expresses a strong preference 
for chloroform as being more 
convenient, and as some 
persons, according to him, 
cannot be brought under the 
influence of ether. Some 
French authorities have de- 
scribed pneumonia and bron- 
chial irritation as following 
the inhalation of ether. 13 
deaths have been collected 
by Mr. Cawtley Dawson, of 
Leeds (Brit. Med. Journal, 
March, 1878), as having been 
caused by its use, with prob- 
ably five in America, the 
fatal result having occurred 
from asphyxia, probably 
caused by the intense cold 
produced by the ether con- 
tracting the small blood-ves- 
sels of the lungs to an injur- 
ious degree. 



1THERS. 143 



Mode of Administration. 

It is most important that no air be admitted during ether 
administration, as most violent resistance and dangerous 
struggling supervene if the vapor be not inhaled in a state 
of purity. Non-attendance to this point caused ether to 
fall into discredit soon after its original introduction, and it 
is only lately that we have been fully convinced that, by 
using this simple precaution, we may readily obtain com- 
plete anaesthesia and perfect muscular relaxation in from 
three* to eight minutes. Various inhalers have been devised 
to fit tightly over the mouth and nose, and it is here essential 
that some instrument of the kind should be used. 

When operating by artificial light, do not forget the in- 
flammable nature of the vapor of ether. 1 

JEther Aceticus — Acetic Ether — Acetate of 
Ethyl, U. S. 

Dose, gtt. xv-30. (0.9-1.9 C. C.) Is a constituent of 
Spiritus Odoratus and of Tinctura Ferri Acetatis. It is 
locally irritating. It can be used as an anaesthetic (H. C. 
Wood), but is slow in its action. Upon the system, it acts 
like aether, being stimulant and antispasmodic. It has been 
applied, with friction, to relieve pains in joints. 

[For Mr. Clover's observations upon the Choice of Anaes- 
thetics, see page 59.] 



[JEtherea— Ethers. 

The officinal Ethers are : — 

.iEther. Chloroformum Purificatum. 

iEther fortior. Oleum iEthereum.] 



1 [The relative danger from the use of the vapor of ether and of 
chloroform may be inferred from the fact that while the former is 
administered with impunity without auy admixture with air, the 
latter requires to be diluted with from 95 to 97 per cent, of air, and 
even then the patient must he carefully watched.] 



144 ALCOHOL. 



ALCOHOL—ALCOHOL. 

I A liquid composed of 91 per cent, by weight (94 per cent, by volume) of 
Ethyl Alcohol, and 9 per cent, by weight (6 per cent, by volume) of 
water. Sp. gr. 0.820 at 15. 6° C. (60° F.) and 0.812 at 25° C. 
(770F.). 

Officinal Preparations, U. S. 

Alcohol Dilutum. (One-half water.) 

Spiritus Vini Gallici. Brandy (about 50 per cent, 
alcohol). Obtained by the distillation of fermented grapes, 
and at least four years old. 

Spiritus Frumenti. Whisky (about 50 per cent, 
alcohol). Obtained by distillation of fermented grain (usu- 
ally corn, wheat, or rye), and at least two years old. 

Spiritus Myreise. Bay rum (for external use). 

Spiritus Odoratus. Cologne water (for external use). 

Alcohol makes a good menstruum, and is the basis of the 
Spirits and Tinctures of the Pharmacopoeia ; the former 
being solutions of volatile substances in alcohol, the latter 
generally containing the active principles of plants obtained 
by maceration and percolation. 

Vinum Album. White wine. A pale, amber-colored 
or straw-colored, alcoholic liquid, made by fermenting the 
unmodified juice of the grape, free from seeds, stems and 
skins. Alcoholic strength 10—12 per cent. 

Vinum Album Fortius. Stronger white wine. 
Alcoholic strength 20-25 per cent. 

Vinum Rubrum. A deep red alcoholic liquid made 
by fermenting the juice of colored grapes in presence of their 
skins. Alcoholic strength 10-12 per cent. 

Vinum Aromatieum. Aromatic wine (for exter- 
nal use). (See p. 95.) 

(Spiritus Genevan, Gin, is not officinal ; the Spiritus 
Juniperi Compositus of the Pharmacopoeia may be regarded 
as its equivalent.) 

Tests. 

The chemical test consists in removing the contents of the 
stomach, mixing them with distilled water, filtering, and dis- 
tilling in union with carbonate of potassium or sodium; the 
product is mixed with fused chloride of sodium, and again 
distilled. Alcohol, if present, will be found in the receiver.] 



ALCOHOL. 



145 



Antidotes. 

The treatment of acute alcoholic poisoning must consist in 
removing all the spirit from the stomach by means of the 
stomach-pump, and endeavoring to rouse the patient from 
his perilous state of coma by cold affusions, strong coffee, 
surface stimulation and galvanism, whilst artificial respira- 
tion may be employed to stimulate the flagging breathing 
powers. In more chronic cases, withdraw all stimulant 
absolutely and at once ; insure sleep by chloral and bromide 
of potassium ; and try to diminish the morbid craving by 
capsicum, mix vomica, the mineral acids, and a liberal and 
varied diet. 

Local Actions. 
Physiological. 

Alcohol has some external 



astringent properties from its 
power of hardening albumen 
and thus condensing the tis- 
sues, whilst, from its rapid 
evaporation, it produces a 
cooling effect. [By its con- 
stringing effects upon the 
smaller vessels and nerves, 
it checks active congestion, 
reduces inflammatory action, 
and relieves pain.] 



Therapeutical. 

This hardening process has 
been turned to practical ac- 
count for the prevention of 
bedsores, and alcohol is also 
a usual ingredient in the now 
somewhat old-fashioned spirit 
or evaporating lotions. [Al- 
cohol has been used with 
great success by Ollive (La 
France M^dicale, No. 28, 
1882) as a topical application 
for acute inflammation of cel- 
lular tissue ; pure concen- 
trated (80° or 90°) alcohol 
being applied on compresses 
of cotton wadding, and fre- 
quently renewed. There is 
marked relief of pain, and 
the inflammation is decidedly 
retarded or aborted. 1 ] 



Internal Actions and Uses. 
1. On Brain and Nervous 1. A moderate quantity of 



System. — Alcohol primarily 
stimulates the cerebral cen- 



alcohol stimulates the mental 
faculties, whilst larger doses 



13 



[Phila. Med. Times, 1882, p. 459.] 



146 



ALCOHOL. 



tres by dilating their arte- 
ries, and so admitting more 
blood ; secondly, excitement 
supervenes with impaired 
muscular co-ordination, and 
finally coma, which may 
prove fatal if the dose taken 
be sufficiently large. Whilst 
it may also in small doses 
stimulate the spinal cord, in 
larger quantities it undoubt- 
edly weakens the functions 
of this structure, causing in- 
disposition for active exer- 
tion, as well as actual want 
of power. This has been 
proved by the experience of 
campaigns, but more espe- 
cially that in Ashantee, where 
it was found that alcohol dis- 
tinctly diminished the power 
of bearing fatigue, and also 
by the experiments of Parkes, 
which showed most conclu- 
sively that 2 or 3 ounce doses 
of spirit given several times 
per diem to a couple of 
healthy men engaged in la- 
borious work, caused a slight 
primary increase of energy, 
but a secondary well-marked 
indisposition for muscular ex- 
ertion, with actual diminution 
of bodily vigor. Dr. Wilks 
has also drawn attention to a 
remarkable series of cases in 
which paraplegia, and numb- 
ness, anaesthesia and violent 
shooting pains have been 
caused by the excessive and 
long-continued use of alcohol. 
On the sympathetic sys- 
tem, the effects are somewhat 



become narcotic and even 
anaesthetic. In chronic nerve 
debility, as in neuralgia, we 
may often relieve pain by the 
use of stimulants ; but these 
are precisely the class of cases 
in which habits of intemper- 
ance are most readily formed. 
Nothing seems better 
proved than the fact that 
alcohol lessens the capacity 
for actual muscular exertion, 
and it is therefore well to 
advise sportsmen, soldiers, 
and others, who are about to 
undergo severe bodily fatigue, 
to reserve any stimulant until 
their day's work is over, 
when it may be of real ser- 
vice. In the Ashantee cam- 
paign, a ration of rum, on 
reaching camp at night, 
seemed to revive the men 
after their labors. 



In those cases of chronic 
alcoholic poisoning described 
by Wilks, we must follow his 
advice, and entirely cut off 
all supplies of strong drink. 



ALCOHOL. 



147 



varied ; for although the dila- 
tation of certain vascular 
areas must depend on para- 
lysis of these nerves, there 
seems no doubt that, as Binz 
has shown, alcohol in inflam- 
matory conditions stimulates 
the sympathet ; c, contracts 
the arterioles, and prevents 
that migration of the white 
corpuscles which constitutes 
the essence of this morbid 
pi'ocess. The chronic abuse 
of alcohol causes nervous 
tremors and debility, gradu- 
ally leading up to that semi- 
maniacal state known as de- 
lirium tremens, in which the 
victim is haunted by the con- 
stant presence of spectral 
illusions, preventing sleep, 
and finally wearing him out, 
if unchecked. The brain, 
like most of the internal or- 
gans of the body, suffers in 
alcoholism from the contrac- 
tion of new areolar tissue 
pressing upon and obliterating 
some of the nervous elements. 

2. On Heart and Circula- 
tion Alcohol in moderate 

doses has a stimulating in- 
fluence on the heart; and 
dilatation of the peripheral 
vessels and of those of the 
brain is produced. 

In chronic alcoholism we 
find a degenerated condition 
of the larger vessels, known 
as atheroma. 



This is, no doubt, one ex- 
planation of the beneficial 
action of alcohol in some 
cases of acute inflammation. 



The treatment of delirium 
tremens consists most essen- 
tially in withholding all stim- 
ulant, in keeping the patient 
in a cool, quiet, dark room, 
in forcing him to take small 
and oft-repeated supplies of 
nourishment, and in cautious- 
ly prescribing narcotics, of 
which chloral hydrate is the 
best. [For this condition, 
strychnine or tincture of nux 
vomica often proves of great 
value.] 

2. To its action on the cir- 
culation, however, we must 
ascribe a good deal of the 
beneficial influence of alcohol 
in the treatment of disease. 
When the powers of life show 
signs of failing, when the first 
sound of the heart grows 
weak, the pulse feeble, com- 
pressible, and irregular, when 
syncope threatens, and deli- 
rium is beginning, the indi- 
cations for the administration 
of alcohol are complete, and 



148 



ALCOHOL. 



3. Respiration and Tem- 
perature. — The old observa- 
tions of Liebig seemed to 
show that alcohol was a respi- 
ratory food, and was largely 
burnt off in the lungs, thus 
aiding in the production of 
animal heat. It is now 
found, however, that under 
its use the carbonic acid given 
off from the lungs is dimin- 
ished, and that the body heat 
is lowered. The carbonic 
acid, however, is probably 
only apparently diminished, 
because it is retained in the 
blood. When but small 
doses are taken, only a slight 
cooling effect is produced, 
whilst large quantities may 
reduce the temperature by 
two or three degrees, the ex- 
planation being partly that 
the dilatation of the cutaneous 



it will be found to act well 
when the tongue moistens, 
the pulse gains in volume and 
regularity, sound refreshing 
sleep is obtained, and the 
temperature falls. It is, of 
course, difficult to lay down 
exact rules as to the precise 
stage of fevers at which we 
may best prescribe alcohol, 
but ordinarily we should do 
so in typhus about the seventh 
day, in typhoid the twelfth, 
in smallpox when the secon- 
dary fever is developed, and 
in acute inflammations, gene- 
rally, when the heart begins to 
fail, and the nervous system 
to show indications of debility. 

3. This lowering of tem- 
perature must also be ex- 
plained by diminished tissue 
metamorphosis, and by a par- 
tial arrest of the oxygen- 
bearing function of the red 
corpuscles of the blood, as 
well as by the paralyzing in- 
fluence of the alcohol on the 
protoplasm of the heat-pro- 
ducing cells, as illustrated by 
the way in which it checks 
the action of yeast (Binz). 

That some of this action is 
chemical is proved by the 
fact that alcohol lowers post- 
mortem temperature. It is 
therefore evident that we 
must warn persons about to 
be exposed to severe cold of 
the fallacious nature of the 
old notion that alcohol fur- 
nishes true warmth. 

There can, however, be no 



ALCOHOL 



149 



vessels enables more blood to 
be removed from the heat- 
producing centres, spread out 
and cooled in the wide sheet 
of the superficial circulation, 
and then returned, to abstract 
more warmth from the inter- 
nal organs. Another curious 
fact is that alcohol also dimin- 
ishes the power of resistance 
to cold ; and this has been 
proved not only by the expe- 
rience of Arctic voyagers, but 
by the following experiment : 
If we place two animals, one 
of which lias been dosed with 
alcohol, in a chamber of which 
the temperature has been re- 
duced to 10° below freezing 
point, both will speedily be 
benumbed to sleep ; but whilst 
the healthy animal will be 
supported by the combustion 
of its tissues and survive the 
shock, its companion will 
perish from this heat-pro- 
ducing process being inter- 
fered with by the spirit. 

4. Intestinal Tract In 

small doses, alcohol stimu- 
lates the appetite and in- 
creases the supply of gastric 
juice: but if given in larger 
quantities, this secretion is 
checked, nausea is produced, 
and the desire for food dis- 
appears. In the advanced 
stages of chronic alcoholism 
the stomach is injured by the 
contraction of the new areolar 
tissue obliterating its glands, 
and hence we find dyspepsia, 

13 



doubt that we may often alle- 
viate the evil effects of a chill 
by a dose of spirit [especially 
in the form of a hot toddy], 
which releases the capillaries 
of the skin from their state 
of morbid contraction, and 
thus prevents congestion of 
internal organs. As an an- 
tipyretic, alcohol can hardly 
be used with safety, as at 
least two ounces of absolute 
alcohol are required to lower 
the temperature of an adult. 



4. Alcohol is thus often 
beneficial in the case of weakly 
persons, and more especially 
at the extremes of life, by 
giving tone to the digestive 
organs and aiding the due as- 
similation of food. Although 
its use is by no means essen^ 
tial to the healthy, it is of 
great service to dwellers in 
large towns, and others whose 
mode of life involves much 
mental strain. We must in- 
variably lay down the rule 



150 



ALCOHOL. 



with morning vomiting, a 
very common symptom in 
drunkards. 



that, save in illness, alcohol 
should never be taken on an 
empty stomach, that the freer 
dilution in which it is im- 



5. Secreting Organs Al- 
cohol stimulates the liver, and 
this organ is one of the first 
to suffer from chronic abuse 
of stimulant, the areolar tis- 
sues being irritated, and an 
increased formation taking 
place, which gives a primary 



two ounces per diem should 
be about the limit of quan- 
tity. Although some persons 
seem to get on better without 
anything stronger than water, 
others are undoubtedly bene- 
fited by a moderate allow- 
ance, and the present state of 
science does not allow us to 
give dogmatic opinions on the 
general questions involved, 
without the careful study of 
individual constitutions. 

Binz values alcohol as a 
food in fevers, not as actually 
building up the tissues di- 
rectly, but as an easily burn- 
ing fuel, from whose combus- 
tion, in oft-repeated small 
doses, the heat required to 
generate vital force may be 
derived, sparing the reserve 
of fat in the body and pro- 
ducing force. 

Frankland puts down the 
force-producing power of al- 
cohol as 7 to coal 8 ; but we 
must not forget the limited 
power of the system to draw 
upon and utilize this fuel. 

5. Rutherford found that 
pure alcohol had no effect 
upon the biliary secretion. 



ALCOHOL. 



151 



enlargement to the organ. 
These newly formed struc- 
tures, however, having the 
tendency to shrink or con- 
tract, gradually obliterate the 
true secreting elements of the 
gland, which grows smaller 
and harder, ascites eventually 
following from pressure on 
the portal vein and obstructed 
return of blood from the ab- 
dominal circulation. Wine 
appears to retard salivary 
digestion. 



Kidneys Alcohol has no 

specially well-marked effect 
on the urinary secretion, but 
the kidneys may also suffer 
from the cirrhotic degenera- 
tion just described. 



The inhibitory influence of 
wines on starch digestion is 
caused by their acidity, and 
may be neutralized by the 
addition of an alkali. 

Chronic kidney disease is, 
therefore, a very common 
symptom in the victims of in- 
temperance. 



Mode of Elimination. 

Alcohol very rapidly enters the blood, and is rapidly given 
out, in small part at least by the breath, but it probably 
" undergoes combustion to a great degree in the body, main- 
tains or increases the body weight, and prolongs life on an 
insufficient diet. It is therefore entitled to be reckoned as a 
food" (Brunton). Much discussion has been expended on 
its elimination or combustion, and some years ago the hopes 
of temperance agitators were much raised by the apparent 
results of experiments put forward by two French observers, 
which seemed to prove that all the ingested alcohol is given 
out unchanged in the urinary secretion. Anstie and Dupre, 
however, showed the fallacy of this by pointing out that even 
the urine of the most rigid abstainers contains a substance 
which cannot, by the chromic acid test, be distinguished 
from alcohol, and it has since been asserted that this may 
actually ^be alcohol derived from converted liver sugar. 

Opinions differ much as to the ultimate destination of 
alcohol in the system. Some hold that it is first converted 



152 ALCOHOL. 

in the blood into aldehyde, then acetic acid, and finally 
carbonic acid and water. Wanklyn holds that it may be 
converted, partly at least, by oxidation into glycol. 

Binz believes it to be completely destroyed in the 
organism, as he has never found more than three per cent, in 
the urine, and as, according to him, no secondary product 
has ever been found. 

As regards the dose of alcohol, it is manifestly impossible 
to lay down any hard-and-fast rules, as we must of necessity 
be guided by the constitution of the patient and the symptoms 
of his special case. We may say that from two to eight ounces 
daily of brandy may be sufficient in typhus or any acute ill- 
ness, and that 16 oz. may be looked upon as the quantity 
which it is well not to exceed. In a state of health, 2 oz. 
absolute alcohol per diem is usually considered a maximum 
allowance, every care being taken to insure purity. The 
adulteration with fusel oil causes headache and much diges- 
tive derangement ; whilst picrotoxine, which is occasionally 
added to beer, will produce epileptiform seizures. 

It is of some importance to consider the forms of alcohol 
best adapted for varying cases, and we may say, generally, 
that champagne acts well in sudden and rapid sinking, whilst 
good whisky or brandy may be recommended in ordinary 
acute illness. Port and Madeira are well suited for cases of 
debility; and in convalescence from acute illness and diges- 
tive feebleness, malt liquors and Burgundy [or the wine of 
Erythroxylon Coca, " Vin Mariani"] will often be found to 
be of great service ; but we must always beware of the possi- 
bility of leading our patients into disastrous habits of self- 
indulgence by a lack of precision in our directions as to 
quantity. 

The following are the relative proportions of absolute 
alcohol in the liquors most commonly in use : — 

Brandy, gin, whisky . . . . 30 to 50 per cent. 
Sweet Spanish and Italian wines 
Hock and claret .... 

Edinburgh ale 

Bavarian beer ..... 
Stout 

[Spiritus iEtheris Compositus is an alcoholic solu- 
tion of ether, impregnated with oil of wine (stronger aether, 
30; alcohol, 67; ethereal oil, 3 parts), and is popularly known 
as Hoffmann's anodyne liquor. It is used in hysteria and 



30 to 50 


per 


13 to 17 




8 toll 




6 




4 to 5 




4 





GARLIC. 153 

nervousness. Dose, n^x to f'3j (.60 to 4. Gra.).] (See 
^Ether.) 

[By the action of sulphuric and nitric acids upon stronger 
alcohol, nitrous ether is produced, which, in combination 
with alcohol, is called spirit of nitrous ether. 

Spiritus iEtheris Nitrosi is " an alcoholic solution 
of ethyl nitrite (C 2 H 5 N0 2 : 75) containing five per cent, of 
the crude ether" (the sweet spirit of nitre). This prepa- 
ration, in doses of from 2 to 8 grammes (from ^ fl. drachm 
to 2 fl. drachms), is diuretic and diaphoretic, and is much 
used in feverish conditions.] 



[ALLIUM— GARLIC. 

The bulb of Allium sativum, Linnt (N. 0. Liliacece). 
Dose, of the fresh bulbs, 3j-ij (4 to 8 Gm.). 

Officinal Preparations, U. S. 

Syrupus Allii. Dose, f'3j, or for an infant n^v-x 
(.30 to 4. Gm.). (Garlic 15, dilute acetic acid 40, sugar 60 
parts). 

Garlic is a stimulant expectorant, and is used with good 
effect in the latter stages of catarrhal bronchitis, or suffocative 
catarrh in young children, in which cases it may also be used 
as a poultice to the chest. These poultices, composed of the 
freshly boiled bulbs pounded into a mass, used either alone 
or with an equal quantity of linseed meal, may also be used 
in infantile convulsions, applied to the back and legs, or the 
oil of garlic may be used as a rubefacient. 

The following would be an appropriate formula for the 
catarrhal bronchitis of infants : — 



R. 



S. 



Syr. allii 
" ipecacuanha 
" tolutani 


'S; 


or 32 
" 12 
" 20 


" acacise 
Tinct. opii camphorat. 
Dose, Tt^xx to t*3j.] 


t'Svj ; 
f3y; 


" 24 
" 8 



Gm. 



M. 



154 ALOES. 



ALOE— ALOES. 

[ The inspissated juice of the leaves of Aloes socotrina. Lamarck 
(/V. 0. Liliaceai). 

Officinal Preparations, U. S. 

Extraetum Aloes Aquosum. (Watery extract.) 
Dose, gr. ss-v (.03-30 Gm.). 

Aloe Purifieata, purified aloes. Dose, gr. j-xx (.06 
to 1.35 Gm.). 

Pilulae Aloes. (Aloes and soap, equal parts.) 2 grs. 
of aloes in each pill. 

Pilulae Aloes et Asafcetidae. (Aloes, asafcetida, 
and soap, equal parts.) 1-J- grs. aloes in each pill. 

Pilulae Aloes et Mastiches. (Aloes, 4 parts, mastic 
and rose leaves, aa 1 part.) 2 grs. in each pill. 

Pilulae Aloes et Myrrhae. (Purified aloes, 2 parts, 
myrrh, 1 part, aromatic powder, -J- part.) 2 grs. in each pill. 

Pilulae Rhei Compositae. (Each pill contains puri- 
fied aloes gr. jss, rhubarb gr. ij, and myrrh gr. j, with oil 
of peppermint.) 

Pilulae Aloes et Ferri. (Purified aloes, sulphate of 
iron and aromatic powder, aa gr. j, in each pill.) 

Tinetura Aloes. (10 per cent.) Dose, f3ss-ij (2 to 
8 Gm.). 

Tinetura Aloes et Myrrhae. (Purified aloes and 
myrrh, each 10 per cent.) Dose, f3ss— ij (2 to 8 Gm.). 

Vinum Aloes. (Aloes, 6 parts, cardamom 1, and ginger 
1, in 100 parts of stronger white wine.) Dose, f3j-iv (4-16 
Gm.). 

Aloes enters into Tinetura Benzoini Composi ta (2 per cent.), 
and Extraetum Colocynthidis Compositum (50 per cent.).] 

Physiological Action. Therapeutical Action. 

Aloes acts on the lower Aloes is a very certain, ef- 

part of the large intestines, ficient, and mild purgative 

stimulating its peristaltic [in doses of ten to twenty 

movements, and causing the grains], acting, however, 

evacuation of formed and only rather slowly, and seldom 

slightly softened feces. It producing its effects before 

also increases the secretion of from six to twelve hours, 

bile, being, in large doses, a It occasionally, however, 

very powerful stimulant of the gripes, and is, therefore, 



ALOES. 



155 



usually given in combination 
with other remedies which 
diminish this tendency, and, 
from its action on the lower 
bowel, it must be avoided in 
any local inflammatory con- 
dition, or in the acuter forms 
of haemorrhoids. Oppolzer 
[and Fordyce Barker] re- 
commended aloes, as below. 

Its mild and slow action 
has caused it to be much used 
in dyspepsia ; it forms a prin- 
cipal constituent of most din- 
ner pills; and it is also a 
popular remedy in habitual 
constipation. It has also em- 
menagogue properties de- 
pending partly, no doubt, on 
the sympathy of contiguity. 
In the form of pill or de- 
coction, and given, as laid 
down by Graves, at the time 
when the catamenia are natu- 
rally expected, it often proves 
most efficient. [The purified 
aloes should be used, as the 
commercial aloes contains 
impurities.] 

Dose, etc. 

The most useful preparations of aloes are, the compound 
decoction (P.Br.), dose fjfj to f*ij; 2 the pil. aloes et 
myrrhae; and aloes and iron, dose gr. v to xv (.30 to 1. Gm.). 
fy. Ferri sulph. gr. xx ; 

Ext. aloes aq. 5J '■> 

Extracti taraxaci q. s. 

M. Div. in pil. lx. 
One morning and evening. 

Oppolzer. 

1 The National Dispensatory, Phila., 1879, p. 137. 

2 [This is a favorite preparation of the British Pharmacopoeia. 
It contains aloes, licorice, carbonate of potassium, myrrh, saffron, 
and tincture of cardamom, and is gently cathartic] 



liver. It renders the bile 
more watery, but at the same 
time increases the secretion 
of biliary matters by the 
liver, and some authorities 
hold that its purgative action 
is merely secondary to this. 
A good deal of congestion 
about the rectum is produced, 
and a sympathetically stimu- 
lating effect may extend to 
the uterus, and tend to excite 
its functions, whilst chronic 
piles even may be benefited 
by its stimulating influence. 

[The active principle is 
termed Aloin, which is 
sometimes used instead of 
aloes in from one- half to one- 
third of the dose. " Its ca- 
thartic action is said to be 
uniform, rather more speedy 
than that of crude aloes, and 
unattended by griping." 1 ] 



156 MARSHMALLOW — ALUM. 

[For chronic constipation : — 

R. Ext. belladonnse ale. gr. ^ ; or ( 005 Gm. 

" colocynth. coinp. 
Aloes, aa gr. jss ; " t09 " 

01. anisi TT}j " 106 " 

Ft. pilnla et mitte tales No. xij. 

S. Dose two or three at bedtime. 

For chronic constipation, in women with uterine dis- 
order : — 



££. Aloes purificat. gr. ij 

Ferri sulphat. 

Terebinth, alb., aa gr. j ; 

Ft. pil. sec. art. 
S. Dose, one or two pills per diem. 



12 Gm. 

06 " 



Pulvis Aloes et Canellae (Pharm. 1870) is no longer offic- 
inal, though still used as an emmenagogue in doses of ten 
or twenty grains. It contained Aloes, 8 parts; Canella 
bark, 20 parts. It is sometimes called for by the vulgar 
name Hickory-piccory (Hiera-picra). 

Infusions or suppositories of aloes may be used against 
ascarides.] 



[ALTHiEA— MARSHMALLOW. 

The root of Althcea officinalis, Linne (N. O. Malvacece). 

Officinal Preparation. 

Syrupus Althaea (4 per ct.) used as a vehicle. 

Marshmallow is a demulcent, as it contains chiefly muci- 
lage and starch. It contains no tannin, but has about 2 per 
ct. of Asparagin, an organic principle with diuretic proper- 
ties. It is occasionally exhibited as a decoction in fevers, or 
inflammation of mucous membranes. In the form of a con- 
fection it is popular as a pectoral. The syrup is a new in- 
troduction into the Pharmacopoeia as a vehicle for cough 
mixtures. It should be freshly made.] 



ALUMEN—ALUM. 

[Potassa Alum.~\ 

Dose, as an emetic, gr. x to xx (.60 to 1.30 Gm.), or, as 
a purgative, gr. xv to 3j (1- to .4 Gm.). 



ALUM. 



157 



Alumen Exsiecatum. Dried alum. Dose, gr. v- 
x (.30 to .65 Gm.). 

Aluminii Hydras. Hydrate of Aluminium. Dose, 
gr. iij-xx (.20 to 1.30 Gm.).] 

Local Action. 



Physiological. 

Alum, used externally, 
tends, like most astringents, 
to contract the bloodvessels 
and condense the tissues by 
coagulation of their albumen. 



Therapeutical. 

It is, therefore, much em- 
ployed as an astringent lotion 
in conjunctivitis, leucorrhaea, 
gonorrhoea, and as a gargle 
in sore throat. [Dried alum 
is a mild escharotic for exu- 
berant granulations, etc.] 



Internal Actions and Uses. 



1. On Nervous System. — 
Alum seems to have some 
power in relieving spasmodic 
action. 



2. Circulation This, no 

doubt, is intimately connect- 
ed with No. 1, as the con- 
traction of the bloodvessels 
and internally astringent ef- 
fects which follow the use of 
alum are probably dependent 
on nervous influence. 

3. On Secretion. — Alum 
occasionally acts both as an 
emetic and a purgative. 

14 



1. It is, therefore, benefi- 
cial in some cases of whoop- 
ing-cough, and in colica pic- 
tonum. [In whooping-cough 
it is given in small doses of 
gr. j-ij (.06 to .12 Gm.), in 
syrup and water several times 
daily. It is also one of the 
best direct emetics in croup. 
Dose, 3ss (2 Gm.), repeated 
every half hour if necessary.] 

2. Alum has been used for 
internal hemorrhage, and to 
check excessive sweating, and 
its action in whooping-cough 
is also largely due to its astrin- 
gent properties, as it is most 
useful in the later stages, 
when profuse secretion has 
been established. 

3. This also explains its 
use in colica pictonum. 



158 SULPHATE OF ALUMINIUM — AMMONIAC. 

Use. 
In lotion, gr. ij ad x, or: — 

I£. Aluminis 
Aquae rosse 

Lotion in catarrhal ophthalmia. 

ty. Aluminis 

Acidi sulphurici dil. 

Sjrupi limonis 

Aquae 
S. Capiat cochleare magnum secunda quaque hora. 

In colica pictonum. 
As a purgative, gr. xl to 3j. 

Glycerinum aluminis is a recent addition to the Br. P. 
[Dried alum may be given in pill, gr. ij (.12 Gm.), in 
hcemoptysis.] 



gr. x; 


or 




[60 Gm. 




f3iv; 


a 


128 


" 


M 


5i.i; 




or 


'8 


Gm. 




f3.i; 




C( 


4 


1 1 




f§j ; 




(( 


32 


n 




f^iij ; 




tt 


9G 


<< 





M. 



[ALUMINIUM SULPHAS— SULPHATE OF 
ALUMINIUM. 

A1 2 (S0 4 ) 3 18H 2 0; 666. 

The sulphate of aluminium is antiseptic and astringent. 
It is sometimes employed in 2 to 5 per cent, solutions, as an 
injection in gonorrhoea and leucorrhcea. It has also been 
used to fill carious teeth ; and in solution is employed to 
inject and preserve subjects for dissection.] 



[AMMONIACUM— AMMONIAC. 

A gum-resin obtained from Dorema Atnmoniacum, D. (N. 0. 
Umbelliferce, Orthospermce) . 

Officinal Preparations, U. S. 

Mistura Ammoniaci. (4 per cent, emulsion.) Dose, 
fjsa (16 Gm.). 

Emplastrum Ammoniaci. (Ammoniac treated 
with acetic acid.) 

Emplastrum Ammoniacum cum Hydrargyro. 
(Ammoniac 72, mercury 18, with lead plaster, sublimed 
sulphur, diluted acetic acid, and olive oil.) 



AMMONIA. 159 



Internal Effects. 

Ammoniac may be used in chronic bronchitis with defec- 
tive secretion, but its systemic influence is not very evident. 
It is given in substance (dose gr. x-xxx) or rubbed up with 
water so as to form the Mistura Ammoniaci, or milk of am- 
moniac. The pills (squills gr. ss, ginger, ammoniac, aa 
gr. ij with soap), not now officinal, are expectorant and 
stimulating. The plasters are resolvent and mildly counter- 
irritant, being useful in enlarged joints and scrofulous tumors. J 



AMMONIA— AMMONIA. 

[Officinal Preparations, U. S. 

Aqua Ammoniae Fortior. (Contains 28 per cent. 
by weight of the gas.) 

Aqua Ammoniae. (Contains 10 per cent, by weight 
of gaseous Ammonia.) Dose, n^ij-v (.13 to .65 Gm.j. 

Linimentum Ammonias. (Aq. Amnion. 30, cotton- 
seed oil 70.) 

Liquor Ammonii Aeetatis. (Spirit of Mindererus.) 
Contains about 1\ per cent, of this salt. Dose, f^ss-j (16. 
to 32. Gra.). 

Spiritus Ammoniae. (10 per cent, solution in alco- 
hol.) Dose, n^x-xv (.60 to 1. Gm.). 

Spiritus Ammoniae Aromatieus. (Contains Am- 
monium Carbonate 4 per cent.) Dose, f 3 s s-j (2. to 4. Gm.). 

Ammonii Benzoas. Dose,gr.x-xx(.60 to 1.30 Gm.). 

Ammonii Bromidum. Dose,gr.x-xv (.60 to l.Gm.). 

Ammonii Carbonas. Dose, gr. x (.60 Gm.), as an 
emetic gr. xxx (2 Gm.). 

Ammonii Chloridum. Dose, gr. v-xx (30 to 1.30 
Gm.). 

Ammonii Iodidum. Dose, gr. v-x (.30 to 1 .30 Gm.). 

Ammonii Nitras (used in making Nitrous Oxide). 

Ammonii Sulphas (used in making Ammonio-ferric 
Alum). 

Ammonii Phosphas. Dose, gr. v-xx (.35 to 1.30 
Gm.). 

Ammonii Valerianas. Dose, gr. ij-v (.12 to .30 
Gm.). 



160 



AMMONIA. 



Dose, gr. v-x (.30 to 
iij-x (.18 



Dose, 



Dose, gr. x-xxx (.65 



Ferri et Ammonii Citras. 
.65 Gm.). 

Ferri et Ammonii Sulphas 
to .65 Gm.). 

Ferri et Ammonii Tartras. 
to 2. Gm.). 

Hydrargyrum Ammoniatum, used in ointment.] 

Trochisei Ammonii Chloridi (each containing 
two grains). 

Also enters into Tinctura Guaici Ammoniata, Tinctura 
Valerianae Ammoniata and Glycyrrhizinum Ammoniatum.] 



Poisoning. 

If given in large quantities, ammonia may cause death by 
inflammation of the stomach and intestines; and, according 
to Richardson, it may also kill by dissolving the red corpus- 
cles of the blood. 

[Antidotes. 

Vegetable acids and demulcents. The fixed oils may be 
administered, and the usual after-treatment instituted for 
poisoning by the caustic alkalies.] 



Local Action. 



Physiological. 

The stronger preparations 
of ammonia are irritating to 
the skin, causing redness and 
speedy vesication on account 
of their power of dissolving 
the cuticle. 



Chloride of ammonium, on 
the other hand, is rather 
soothing, and cools the skin 
by aiding the speedy evapo- 
ration of fluids. 

The vapor of ammonia is 
stimulating and irritating. 



Therapeutical. 

Ammonia is, therefore, a 
component part of many stim- 
ulating liniments, and is an 
excellent counter-irritant and 
vesicant. It is a good ap- 
plication to the sting of in- 
sects or the bite of poisonous 
snakes. 

Chloride of ammonium 
used to be an invariable in- 
gredient in evaporating lo- 
tions. 

Ammonia is used by inha- 
lation in syncope, and as an 



AMMONIA. 



1G1 



aid in the restoration of per- 
sons poisoned by prussic acid ; 
but care must be taken not 
to allow its vapor to enter 
the air-passages too freely 
during unconsciousness, or 
serious inflammation may be 
produced. 

Constitutional Actions and Uses. 



I. On Brain and Nervous 

System The preparations 

of ammonia, generally speak- 
ing, are stimulant in their 
action, affecting, however, 
rather the ganglionic and 
spinal systems than the brain 
proper, and thus differing 
from alcohol. 



Chloride of ammonium 
has, according to Anstie, the 
property of giving increased 
tone to sensory nerves. 



II. Circulation and Respi- 
ration — Ammonia increases 
the force and frequency of 
the heart's action, this ex- 
plaining some part of its 

1 



I. Ammonia in its various 
preparations is very largely 
used as a stimulant in many 
cases of exhaustion and de- 
bility. It is the best means 
of combating the depressing 
influence of snake-bite : it is 
invaluable in bronchitis, pneu- 
monia, and all typhoid condi- 
tions, being more diffusible 
and less stupefying than alco- 
hol ; whilst in prussic-acid 
poisoning it may be admin- 
istered internally as well as 
externally. 

Chloride of ammonium is 
very serviceable in many 
cases of neuralgia, and in 
those wearing muscular pains 
in hard-worked women and 
others usually described un- 
der the term myalgia. [Am- 
monium bromide has been 
used by Da Costa in acute 
rheumatism in doses of gr. 
xx-xxx, three or four times 
daily.] 

II. It is therefore a very 
generally used stimulant in 
acute disease. 



4 : * 



162 



AMMONIA. 



influence. It 
the respiratory 
the 
and giv- 
muscular 
the bron- 



stimulating 



stimulating 
may also aid 
power by 
respiratory centre, 
ing tone to the 
fibres surrounding 
chial tubes. 

When injected into the 
blood, ammonia has the 
power of dissolving the red 
blood corpuscles as well as 
of interfering with their oxy- 
gen-carrying functions. [In 
cases of fatal ammonia poison- 
ing, the blood, after death, is 
found to be dark and to con- 
tain very little oxygen, nor 
will it absorb the gas and 
become arterialized when agi- 
tated in an atmosphere of 
pure oxygen. The red blood- 
corpuscle is also found to be 
altered and to show unusual 
resistance to the action of 
acetic acid.] And it is also 
supposed to diminish the 
coagulating property of the 
blood and to assist in the 
solution of fibrinous concre- 
tions already formed. 

III. On Secretion — Un- 
der this head it may be con- 
venient to place — 

1. The emetic action which 
is especially developed by 
large doses of carbonate of 
ammonia. This effect is also 
produced by injection into 
the blood. 

2. Ammonia increases the 
secretion from the bronchial 
mucous membrane. 



It has therefore been used 
with success by Richardson 
in those cases where, as after 
delivery, diphtheria, ovari- 
otomy, etc., a clot is forming 
in the heart, and lie recom- 
mends it by injection into 
the veins, stopping short of 
solution of the red corpuscles. 



1. Carbonate of ammonia 
is used as an emetic to assist 
in clearing the air-passages 
from accumulated mucus, and 
in some cases of poisoning. 

2. This, in addition to the 
stimulant action, explains 
the great power of ammonia 
over bronchitis in the weak, 



AMMONIA. 



163 



3. Intestinal — Ammonia 
in large doses increases the 
secretion from the intestines, 



young, or aged, and the later 
stages of pneumonia, where 
it promotes expectoration by 
thinning and rendering the 
sputa less tenacious. 

3. It is never used as a 
purgative ; but this irritating 
action on the bowels may 



and may cause diarrhoea, and render it an undesirable form 



of stimulant in enteric fever. 
It is a useful antacid. 

4. Liquor ammonii ace- 
tatis is one of our best dia- 
phoretics in a great variety 
of feverish conditions. 

5. Chloride of ammonium 
has been successfully used in 
intermittent hematuria. 



it also neutralizes acid secre- 
tions. 

4. Cutaneous Ammonia, 

more especially in the form 
of liquor ammonii acetatis, 
acts freely on the skin. 

5. Urinary No special 

action. [The urine becomes 
more acid, possibly because 
of oxidation of ammonia in 
the system (Bence Jones) ; 
the urea is increased.] 

Finally, ammonia has been employed under various con- 
ditions which cannot conveniently be grouped under any pre- 
cise physiological heading; but these we will consider when 
we refer seriatim to the various preparations of the drug. 

Mode of Elimination. 

Ammonia is very rapidly given out from the system, prin- 
cipally by the urine, also, to a less degree, by the breath 
and sweat. 

Preparations. 

Aqua ammonias fortior and aqua ammonias 1 are seldom 
used internally, but occasionally, as mentioned above, by 
vapor and injection. 

Ammonii carbonas. This is the most active and efficient 
preparation, used as a stimulant in doses of from 3 to 10 
grs., as emetic 30 grs. Some authors have looked upon 
ammonii carbonas as a specific for scarlet fever, but of the 
soundness of this view no sufficient evidence has been pro- 

l 1 Syrup of senega contains 4 parts of water of ammonia in a 
thousand.] 



164 AMMONIA. 

duced. It is nauseous and pungent, and must be well dis- 
guised, milk being a good vehicle. 1 



R. Amnionii carbonati 


s 


gr. xl ; or 


2 50 Gra. 


Tincturse soillae 




f 5U ; " 


8 


Syrupi tolutani 




f5»j; " 


12 " 


Decocti senegse 




fgvij; " 


224 


Misce, fiat mistura. 








S. Capiat unciam unam 


quartti 


quaque hora. 





Stimulating expectorant. 

[RaspaiPs eau sedatif (composed of aqua ammonite fjij, 
sodii chloridum £ij, spiritus camphora3 5"jj aqua Jxxxij) is 
a sedative application for neuralgia.] 

Spiritus ammonia? aromaticus contains nutmeg, lemon, and 
spirit in addition to the ammonia. [This is an agreeable 
preparation either for inhalation or internal administration.] 

Ammonii chloridum. Used as a tonic in neuralgia, in 
doses of from 20 to 30 grs. ; but it is very nauseous, resem- 
bling sea-water in flavor. It is also a common addition to 
expectorant cough mixtures. 



Ammonii chloridi 


jtfj; 


or 


8 


Gm. 


Ext. glycyrrhizge 


1**\ 


" 


16 


<( 


Syrupi tolutani 


fgJ ; 


a 


32 


c< 


Aq. cinnamomi 


ad f §viij ; 


<( 


256 


n 



M. 

S. Capiat unciam unam quartis horis. 

In neuralgia or bronchitis. 

It has also, but with little real foundation, been supposed 
to possess some power of aiding the absorption of lymphatic 
and glandular enlargements, and has been regarded as a good 
remedy in chronic liver disease, and in hepatitis and hepatic 
abscess. [It increases the flow of bile, according to Ringer.] 

Ammonii bromidum seems to have an occasional and un- 
certain influence over whooping-cough, and is thought by 
some to be a good substitute for bromide of potassium in 
epilepsy and other nervous disorders. 

Liquor ammonii acetatis and liquor ammonii citratis P. Br. 
are diaphoretic in doses of from f3'j to f^j (8 to 32 Gm.). 

Gm. 



I£. Liq. ammonii acetatis f ^ij ; or 64 

Syrupi limonis ffj ; "32 

Sp. setheris nitrosi f 5^.1 '■> " 12 

Infusi serpentarise ad f gviij ; " 256 

S. Cap. f §j quartis horis. 



M. 



1 [Carbonate of ammonia is incompatible with syrup of squill or 
syrup of garlic, as they contain acetic acid.] 



BITTER ALMOND — SWEET ALMOND. 165 



AMYGDALA AMARA— BITTER ALMOND. 

The seed of Amygdalus Communis, variety amara, Linne (N. 0. 
Rosacece, Amygdaleos). 



AMYGDALA DULCIS— SWEET ALMOND. 

The seed of Amygdalus Communis, variety dulcis, Linne (N. 0. 
Rosacece, Amygdalece). 

Officinal Preparations, U. S. 

From the bitter almond: — 

Oleum Amygdalae Amarae. Dose, gtt. J (.01 Gm.), 
in emulsion. 

Aqua Amygdalae Amarae. (1 in 1000.) A flavored 
water. Dose, 5j-ij (-^8 Gm.). 

Syrupus Amygdalae. As a vehicle (Orgeat syrup). 

From the sweet almond : — 

Mistura Amygdalae. As a vehicle. 

Oleum Amygdalae Expressum (a bland oil ; dose, 
3J-ij, as a laxative). 

Unguentum Aquae Rosae. 

Oil of bitter almond, or benzyl aldehyde, is produced as 
the result of the reaction of emulsion on amygdalin in 
aqueous mixture ; it therefore does not pre-exist in the 
almond, and cannot be obtained from sweet almond, because 
amygdalin is not present in the latter (Remington). Hydro- 
cyanic acid is also formed in the same reaction. Artificially 
made oil of bitter almond is free from prussic acid. 

The antidotes to poisoning by the preparations of bitter 
almonds are the same as those of hydrocyanic acid. 

The effects of the oil of bitter almonds upon the system 
are said to be sedative, but as it is likely to be contaminated 
by the presence of hydrocyanic acid, the poisonous symptoms 
manifested will be those of hydrocyanic acid. Bitter almond 
water, and the syrup, are used as vehicles for cough mixtures. 

The bitter almond, being uncertain and dangerous, is 
never used in medicine ; but sweet almonds, in the form of 
the mixture or of powder, are of value as agreeable vehicles 
for the mixture or suspension of other drugs; and Dr. Pavy 
has taken advantage of their nutritive properties to propose 
them as a substitute for bread in saccharine diabetes. 



166 



NITRITE OF AMYL. 



AMYL NITRIS— NITRITE OF AMYL 
(C 5 H U N0 2 ;117). 

[A clear, pale-yellowish liquid, of an ethereal, fruity odor, an aromatic taste 
and a neutral or sliijhtly acid reaction. Insoluble in water, soluble in 
alcohol, ether, chloroform in all proportions.] 

Local Action. 

Nitrite of amyl is not possessed of any local irritant or 
sedative properties. 



Internal Actions. 



Physiological. 

I. Nervous System 1. 

On Brain No special effect 

is produced on this organ 
beyond that resulting from 
dilatation of the cerebral 
vessels, and consisting of a 
sensation of fulness and op- 
pression in the head, throb- 
bing, with giddiness and con- 
fusion of ideas. Crichton 
Browne has observed yawn- 
ing and other movements 
suggesting a specific action 
on the motor centres of the 
mouth. 



2. On Spinal Cord A 

distinct lowering of reflex 
irritability has been observed 
to follow its use. 



Therapeutical. 

I 1. It has been re- 
commended as a remedy for 
epilepsy, in virtue of its di- 
lating powers releasing the 
vessels of the brain from that 
condition of partial spasm 
which is said to be the cause 
of the disease. When given 
during the fit, it fails ; but 
the experience of Crichton 
Browne, confirmed by Weir 
Mitchell and others, shows 
that it has been successful, 
when given before the par- 
oxysm, when a distinct aura 
is felt, and pallor of the face 
observed, indicating anaemia 
of the brain from vascular 
spasm. It is also of service in 
that perilous condition known 
as the status epilepticus. It 
has also been used with some 
success in migraine. 

2. It has been theoreti- 
cally recommended in cases 
of tetanus and strychnine- 
poisoning ; and, in neuralgia, 



NITRITE OF AMYL. 



167 



II. Vascular System 1. 

On Heart After a brief in- 
halation of this drug, the 
action of the heart becomes 
excessively rapid, the face 
flushes, and a violent throb- 
bing in all the arteries is ex- 
perienced ; and if its admin- 
istration is pushed up to 
poisonous limits, there is 
much weakening of the car- 
diac pulsations. 

2. The effect on the arte- 
rial system is one of marked 
dilatation, the vessels enlarg- 
ing, as proved not only by 
general flushing, but by con- 
gestion of the retina, and by 
the free flow of blood from 
cupped surfaces which had 
previously yielded only a few 
drops. The arterial tension 
becomes much lowered, and 
this enlargement of the cali- 
bre of the vessels has been 
proved to depend on a direct 
action of the drug on the mus- 
cular coats of the arteries, 
and not on any intervention 
of the vaso-motor system. 

It has also been proved 
that oxidation is diminished, 
that the haemoglobin of the 
blood is checked in its func- 
tion of absorbing and giving 
up oxygen, and that, previous 
to death, the color of the ar- 
terial and venous blood be- 
comes almost precisely alike. 



its inhalation has apparently 
been followed by relief. 

II 1. The nitrite of amyl 

has been proposed as an anti- 
dote in chloroform poisoning, 
and as a remedy for the pe- 
culiar heats and flushes so 
common in women about the 
menopause. [When chloro- 
form is administered as an 
anaesthetic, nitrite of amyl 
should be at hand for imme- 
diate use in case of syncope.] 

2. In consequence of this 
dilating effect on the vessels, 
amyl has been most success- 
fully used in angina pectoris. 
The essential condition here 
is supposed to be one of spas- 
modic contraction of the 
smaller pulmonary and sys- 
temic vessels, against which 
the heart, generally weakened, 
as it is in this disease, by 
mal-nutrition of its muscular 
structures, finds itself unable 
to cope, and hence the ago- 
nizing distress. Inhalation of 
the drug releases the spasm, 
and so gives ease ; and this 
result follows whether there 
be actual valvular disease or 
not. This explanation of 
Brunton's, who had the merit 
of first using the drug in 
angina pectoris, has been 
disputed of late, Dr. George 
Johnson holding that the rise 
of arterial tension is not the 
primary cause of the agony, 
but is merely a secondary 
reflex result, and that the 



168 



NITRITE OF AMYL. 



III. On Respiration and 
Temperature — During the 
early stage of amyl inhalation 
the respiration is hurried, but 
when the administration is 
further pushed the breathing 
becomes slower, and finally 
extinguished, from the arrest 
of the corpuscular action 
noted above, and from a par- 
alyzing effect on the respira- 
tory nervous centre. The 
temperature tends to fall, 
from the diminution in the 
process of oxidation. 

IV. On the Digestive Sys- 
tem The presence of sugar 

in the urine has been ob- 
served during amyl inhala- 
tion, this being probably due 
to dilatation of the hepatic 
vessels. 



remedy acts solely by reason 
of its antineuralgic virtues, 
seeing that relief is obtained 
with as much certainty when 
the face flushing already 
exists. 

Brunton's views, however, 
seem most in accordance with 
the facts observed ; but which- 
ever side be right, there can 
be no doubt about the accu- 
racy of the evidence brought 
forward in favor of the clini- 
cal superiority of this over 
any other mode of treatment 
for this previously hopeless 
disease. 

III. Amyl has been suc- 
cessfully used during the par- 
oxysm of spasmodic asthma, 
acting, no doubt, by relaxing 
the muscular walls of the 
bronchial tubes, and it has 
also been confidently recom- 
mended as an efficient remedy 
for whooping-cough, an asser- 
tion which experience does 
not confirm. 



IV. Amyl has been theo- 
retically recommended in 
cholera; but there is no 
special evidence in its favor. 
It is said that sea-sickness 
has occasionally yielded to 
its use. 



Mode of Administration, Cautions, &c. 

Amyl is now known to act much more speedily and effec- 
tually when inhaled than when taken by the mouth, and from 



NITROGLYCERINE. 169 

2 to 5 drops placed on a handkerchief are cautiously drawn 
into the lungs until the characteristic flushing is produced. 
It maybe very conveniently used in glass capsules, which the 
patient can carry readily about with him. Remember that it 
is very apt to deteriorate by keeping, and that the druggist's 
stock must frequently be renewed. 

No special accidents are recorded as having arisen from 
its use ; but the caution seems a reasonable one, not to 
recommend it rashly to old persons with brittle or calcareous 
arteries, as the sudden alteration of calibre might, be attended 
with danger. Possibly also it might be advisable not to 
recommend it to very plethoric patients, whose brains are 
already overloaded with blood. 

Anasmic and epileptic patients seem to be specially tolerant 
of its use. 

[In this connection we may consider also the well-known 
explosive agent— Nitroglycerinum, Nitroglycerine — -which 
is not, however, officinal. It is also sometimes known as 
Trinitroglycerin, Glonoin, and in combination with clay, it 
is used for blasting, under the designation of dynamite.] 

Nitroglycerine is a poison exerting a marked effect on 
the nervous system, producing, according to Brunton and Tait, 
" accelerated respiration, paralysis, loss of reflex action and 
apparently, to a great degree, of sensation, and death from 
stoppage of the respiration." In frogs, after death, the brain 
is anaemic and heart empty, but the lungs are engorged with 
blood. 

It has been recommended for epilepsy, headache and 
asthma; it has no smell, but its vapors cause intense head- 
ache, throbbing, and fulness, rapid pulse, perspiration and 
occasional nausea. Oflate, it has been highly praised by Dr. 
Murrell for the relief of angina pectoris ; and clinical experi- 
ence has so amply confirmed his statements that it is now an 
established remedy, not only for the major seizure, but for all 
forms of breathlessness and spasmodic discomfort possessing 
the anginiform quality. Tabellce nitroglycerin! (P. Br.) 
are made of chocolate, and contain T i^ gr. Dose 1 or 2. 
Used in ^-drop doses of a one per cent, [alcoholic] solution, 
every 3 hours, and cautiously increased, marked effects are 
produced, and decided relief afforded, its action being slower, 
but more permanent than amyl nitrite. 
15 



170 STARCH — ANISE. 

[The officinal nitrites (sodium and potassium), in doses 
of gr. j to v or more, have a decided lowering influence upon 
the circulation, respiration and temperature.] 



AMYLUM— STARCH. 

[Thefeeula of the seed of Triticum vulgar e, Villars (N. 0. 
Graminacece). 

Officinal Preparations. 

Amylum lodatum. (Iodine, 5 per cent.) Dose, 
3j-ij (4 to 8 Gm.). 

Glyceritum Amyli. (Starch 10, glycerin 90.) For 
external use. 

Starch is used medicinally as an antidote to iodine, and as 
a demulcent in corrosive poisoning. In the form of a dust- 
ing powder it is applied to the skin of infants to prevent 
chafing and excoriation. It also makes with boiling water a 
bland poultice.] 

Starch is a demulcent, used with advantage to some irri- 
table conditions of skin in the form of the glycerite of starch, 
and also as a medium for enemata. 



ANISUM— ANISE. 

[ The fruit of Pimpinella Anisum, Linne* (N. 0. Umbellifene Ortho- 
spermce). 

Officinal Preparations, U. S. 

Aqua Anisi. (01. anisi, 2 parts per thousand.) As a 
vehicle. 

Oleum Anisi. Dose, gtt. x (.06 to. 65 Gm.). 

Spiritus Anisi. (01. anisi 10, alcohol 90.) Dose, 
5j-ij (4-8 Gm.). 

Anise is carminative and stomachic, and is a favorite 
flavoring ingredient in medicines for children. It enters 
into Tinctura Opii Camphorata and Trochisci Glycyrrhizae 
et Opii.] 

Anise, Fennel, Coriander, Caraway, and Dill are agree- 
able aromatics, stomachics and carminatives. 



CHAMOMILE — ANTIMONY. 171 



ANTHEMIS— CHAMOMILE. 

[The floioer heads of Anthemis Nobilis, Linne (2V. 0. Composites), col- 
lected from cultivated plants. 

Infusum Anthemidis. Dose, fgij (64 Gm.) as a 
tonic ; as an emetic ad lib. 

An .agreeable aromatic ; in small doses it is drunk as a 
tonic, and in large doses the hot infusion is taken as an 
emetic. A poultice is sometimes made of the boiled flowers.] 

Chamomile has usually been considered a substance of no 
special therapeutic interest, being principally used by country 
people in the form of infusion as a remedy for dyspepsia; 
but within more recent years various German authorities, 
quoted by Phillips, have stated that the oil has a powerful 
lowering action on the reflex irritability of the spinal cord, 
and have proposed its use in cases of strychnine-poisoning. 
[It may be administered in doses of T^ij-x (.13 to 62 Gm.]. 



ANTIMONIUM— ANTIMONY. 

[Officinal Preparations, U. S. 

Antimonii et Potassii Tartras. Dose, gr. t l to j 
(.005 to .06 Gm.). 

Antimonii Sulphidum — (the purified tersulphide, 
used in making the oxide). 

Antimonii Oxidum. Dose, gr. ij-iij (.12 to .20 
Gm.). 

Antimonii Sulphidum Purifieatum. Dose, 
gr. J-l (.01 to .06 Gm.). Used in making Antimonium 
Sulphuratum. 

Antimonium Sulphuratum (sulphurated antimony). 
Dose, gr. j-iij (.06 to .20 Gm.). As an emetic, gr. v.— xx 
(.32 to 1.30 Gm.). 

Pulvis Antimonialis (James's powder). (Antimonii 
oxidum 33, calcii phosphas 67.) Dosegr. iij-v (.20 to .30 
Gm.). 

Pilula^ Antimonii Compositae. (Each contains ^ 
gr. of calomel and sulphurated antimony and 1 gr. of 
guaiac.) Plummer's Pills. Dose, 1 or 2. 



172 ANTIMONY. 

Vinum Antimonii (Tartar emetic, about gr. ij to 
f^j). Dose, gtt. x (.60 Gm.) ; as an emetic, f 3j (4 Gm.). 
(Enters into Mistura Glycyrrhizae Composite, 6 parts per 
100.) 

Syrupus Seillae Compositus (contains Tartar 
emetic, nearly gr. j in 3J, or 3 parts in 2000). 

Metallic antimony is not regarded as a poison ; but its 
vapor is said to cause unpleasant symptoms when respired. 

Antimony, Tartarized, generally known as Tartar Emetic, 
is an irritant metallic poison. 

Symptoms of Poisoning. 

Nausea and severe vomiting, hiccough, eardialgia, burning 
heat at the epigastrium, severe colic and purging, small and 
rapid pulse, cold skin, syncope, difficult respiration, vertigo, 
insensibility to external stimulants, painful cramps in the 
lower extremities, and great prostration of strength. 

Morbid Appearances. 

The stomach and intestines often much inflated with gas; 
their mucous membrane red, and covered with a slightly ad- 
hering viscid layer ; the peritoneum of a dark brick-red hue; 
the membrane of the brain displaying marks of inflamma- 
tion.] Death may occur from the collapse following pro- 
longed vomiting and purging, or may be the result of gastro- 
intestinal inflammation. Post-mortem examination of a 
protracted case generally discovers parenchymatous degene- 
ration of the liver and other internal organs. 

[Tests. 

In a solid state, add charcoal, introduce into a test-tube 
and expose to heat ; metallic antimony will be deposited, of 
a grayish-black lustre. In solution, diluted nitric acid causes 
a white precipitate. Sulphuretted hydrogen throws down a 
reddish-orange precipitate. Tannin causes copious, curdled, 
whitish-yellow precipitate. Should matters from the stomach 
be present, the solution must be well agitated with a small 
portion of muriatic and tartaric acid, and filtered previous to 
being experimented upon. 



ANTIMONY 



m 



Treatment. 

Encourage vomiting by free administration of warm water 
and other diluents, or employ the stomach-pump, if neces- 
sary. Infusions, tinctures, or extracts, containing tannin, 
are very useful by decomposing the poison. Give tea, coffee, 
and stimulants. Tannic acid converts the salt into an inso- 
luble tannate.] 

Local Action. 



Physiological. 

Externally applied, tartar 
emetic causes redness and in- 
flammation of the skin, fol- 
lowed by an eruption of pa- 
pules becoming vesicular, and 
finally forming pustules close- 
ly resembling those of small- 
pox. 

Internal Action and Uses 

I. Brain and Nervous Sys- 
tem — Tartar emetic under 
certain conditions, and more 
especially when combined 
with opium, exerts a sedative 
influence on the brain. 

When given in poisonous 
doses, paralysis, probably of 
spinal origin, and attended 
with diminished reflex irrita- 
bility, sets in. 

II. Circulation and Respi- 
ration Antimony is seda- 
tive in its operation on the 
heart and vascular systems, 
the heart's action becoming 
slow, weak, and finally irreg- 
ular, the arterial tension low- 
ered, and the pulse soft and 
compressible. The respira- 
tion also grows slower, and 
an increased secretion takes 



Therapeutical. 

Tartar emetic used to be 
extensively employed in the 
form of ointment as a coun- 
ter-irritant, but was found 
occasionally to cause inflam- 
mation, and to leave unsightly 
scars. 



I. Its use was originally 
recommended by Graves, and 
has been indorsed by Murchi- 
son, in the violent delirium 
of typhus, and it has also been 
employed with benefit in de- 
lirium tremens. 



II. The depressing influ- 
ence of tartar emetic on the 
circulation caused it to be 
very generally used in former 
years in acute inflammations, 
and more especially pneumo- 
nia : but this practice has 
now been almost generally 
abandoned, as it was found 
that such treatment, whilst 
exerting no real influence 



15* 



174 



ANTIMONY. 



place from the bronchial mu- 
cous membrane. 



General muscular relaxa- 
tion is observed. 



III. On Secreting Organs. 

1. Stomach and Intestines 

Antimony is an effectual 
emetic, its action being slow, 
however, and attended by a 
good deal of depression. It 
acts either when swallowed, 
or by subcutaneous injection ; 
but the balance of experiment 
goes to show that in either 
case the effect is produced by 
reflex action following irrita- 
tion of the nerves of the sto- 
mach. Some increase of se- 
cretion from the intestines 
and consequent diarrhoea are 
occasionally observed. 



over the course of the disease, 
tended to reduce the strength 
of the patient, and cause lin- 
gering convalescence. Small 
doses, however, are found use- 
ful in croup [when not diph- 
theritic], and in the broncho- 
pneumonia of children where 
great dyspnoea and fever exist 
with excessive bronchial se- 
cretion ; and it is a good gene- 
ral expectorant in asthma, 
[the first stage of] bronchi- 
tis, etc. 

Its relaxing effects on the 
muscular system were former- 
ly taken advantage of for the 
reduction of hernice and dis- 
locations ; but it has of course 
been quite superseded bychlo- 
roform and other anaesthetics. 
1. Antimony is too slow 
and depressing an emetic to 
be used in cases of poisoning, 
but it is of service in croup, 
whooping-cough, bronchitis, 
etc., where we wish to relax 
the bronchi and get rid of ac- 
cumulated secretions. 

In former years, when an- 
timony was freely given, what 
was called tolerance used to 
be an interesting therapeutic 
result. That is to say, in 
feverish conditions, it was 
found that large quantities of 
the drug might be taken with- 
out producing vomiting; and 
this has been explained by 
the observation that anti- 
mony, to act as an emetic, 
must previously be dissolved 
in the gastric juice, a secre- 



ANTIMONY. 175 

tion which is in great mea- 
sure checked during fever. 
Gubler explains the tolerance 
more simply, by suggestion 
that the system is too weak to 
carry out the energetic series 
of actions causing vomiting. 
2. Skin — Antimony has a 2. Antimonial wine is a 
powerful diaphoretic action. common adjunct to diapho- 
retic mixtures. It has been 
used in small doses with good 
result in psoriasis from its 
chemical relationship with 
arsenic. On account of its 
chemical affinities with ar- 
senic and phosphorus, it has 
been prescribed in scaly skin 
affections, and although my 
own experience hardly bears 
out the success recorded by 
others, several good autho- 
rities, like Malcolm Morris 
and Spender, have faith in 
its use in doses of n^xv-xx 
every three hours. 

Mode of Elimination, etc. 

Tartar emetic rapidly enters the blood, and is eliminated 
by the bile, milk, sweat, and urine, as well as the gastro- 
intestinal glands. 

Form of Administration. 

Tartar emetic, on account of its tastelessness, may be well 
given dissolved in simple distilled water; and Ringer tells 
us, and I have amply confirmed his statements, that we may 
do much good, in some forms of acute bronchitis in children, 
by dissolving a grain of the salt in a pint of water, and 
giving a teaspoonful every quarter of an hour for the first 
hour, and then hourly. 

In the case of adults, when we wish to avoid the nausea- 
ting effects of the drug, we may best do so by the following 
formulae : — 



or 




< ( 


2 


i i 


16 


a 


192 



176 APOCYNUM. 

I£. Antimonii et potassii tart. gr. ij ; or 12 Gri 

Acidi hydrocyanici diluti HI xxx 

Tincturse lavandulse comp. f §ss ; 

Aquae destillatae q. s. ad f §vj ; " 192 " M. 

Dose, f §ss quartis horis. 1 

I£. Liq. opii sed. 2 f ^j ; or 4 Gra. 

Antimonii et potassii tart. gr. j-ij ; " (06 " 

Aqu?e camphorse f§ v j I " 192J " M. 

S. Sumat semiunciam omni hora donee somnus supervenerit. 

Highly recommended by Graves and Murchison in the 
insomnia and delirium of typhus fever. 

[Tartar emetic in broken doses is very useful in acute 
pneumonia, from its action on the skin as well as on the 
respiratory centre. 

fy. Antimonii et potassii tart. 

Pulv. digitalis 

Pulv. ipecac, comp. 
Ft. chart, no. xx. 

S. Capiat unam secunda quaque hora. 
In pneumonia.~\ 



gr- h ; 


or 




03Ghn. 


gr. x ; 


" 




60 " 


gr. xl ; 


a 


2 


60 " M 



[APOCYNUM— APOCYNUM. 

(Canadian Hemp.) 

The root of Apocynum Cannabinum (N. 0. Apocynacece) . 

Dose, in substance, gr. v-xxx (.35 to 2. Gm.). 

Emetic and cathartic in large doses, especially in the 
form of decoction. In smaller doses acts as an expectorant, 
diaphoretic, and diuretic. In chronic nephritis (Bright's 
disease) it may be administered to relieve dropsy.] 



[APOMORPHIN.E HYDROCHLORAS— HYDRO- 
CHLORATE OF APOMORPHINE 

(C 17 H 17 N0 2 HCI— 303.4). 

The hydrocldorate of an artificial alkaloid prepared from morphine. 
(See under Opium.) 

1 [Each dose contains two and one-half minims of dilute hydro- 
cyanic acid. This being the case, the first dose should not exceed 
f'tjj ; to be cautiously increased.] 

2 [Battley's solution, non-officinal. It is about twice tbe strength 
of laudanum.] 



WATER 



m 



AQUA—WATER. 

[Natural water in its purest attainable state. 

Aqua Destillata. Distilled water.] 

Water, both in its external and internal applications, 
enters so largely into medical practice as well as into 
domestic economy, that we cannot begin our studies better 
than by considering very briefly what is definitely known 
regarding its physiological and therapeutical properties. 

[Water in a natural condition is more or less impregnated 
with saline or organic matters, and always contains in solu- 
tion more or less solid, liquid, or gaseous impurities. Pure 
water boils at 100° (212° F.) at the level of the sea; if it 
contain much foreign matter, its boiling point may be raised. 
Mineral waters are those which permanently contain an 
unusual quantity of saline substance in solution. Hard 
water contains carbonate or sulphate of lime and magnesia ; 
the former, being remediable by boiling, is called removable 
hardness, while the latter is permanently hard. Hard water 
will not make a lather with the ordinary alkaline soap, but 
simply curdles, because the lime combines with the fatty 
acids and is precipitated. This is the basis of division of 
water into hard and soft; spring and well water are often 
hard ; rain and river water are usually soft. 

The following classification of water is furnished by the 
Rivers Pollution Commissioners in their sixth report, etc. : — 

I. In respect of wholesomeness, palatability, and general 
fitness for drinking and cooking : — - 

1. Spring water ") Very 

Deep well water ) palatable. 

Upland surface water) Moderately 

Stored rain water ) palatable. 
Surface water from 

cultivated land 

River water to which V Palatable. 



Wholesome 



Suspicious 



Dangerous 



sewage gams access 
Shallow well water 



II. According to softness — 

1. Rain water. 

2. Upland surface water. 

3. Surface water from cultivated land. 



178 WATER. 

4. Polluted river water. 

5. Spring water. 

6. Deep well water. 

7. Shallow well water. 

III. In respect of the influence of geological formation in 
rendering water sparkling, colorless, palatable and whole- 
some by percolation, the following water-bearing strata are 
given as most efficient : — 

1. Chalk. 

2. Oolite. 

3. Green sand. 

4. Hastings sand. 

5. New red and conglomerate sandstone.] 1 

Baths and External Applications. 

It will be found difficult, if not impossible, to balance the 
physiological and therapeutical actions of water in the man- 
ner followed generally throughout this work, and we shall 
therefore give a short collective sketch of the influence 
exerted by it on the various functions of the body. 

It is not necessary for us to do more than refer to the uni- 
versal use of water for washing and bathing purposes, but 
a word or two on the physiological effects of cold baths is 
required. We find that the action of the heart is increased, 
the respiration may become panting and irregular, the tem- 
perature falls, and the destructive metamorphosis of muscular 
tissue is augmented, as indicated by an increased excretion 
of urea ; occasionally albumen appears in the urine, and so 
much mental shock is produced, more especially by sea- 
bathing, as to render this usually excellent tonic inadvisable 
in those of feeble or hysterical constitutions, in the very 
young and old, and in pregnant or menstruating women, 
whilst the tendency to vascular strain must prescribe caution 
towards those in whom we have any reason to suspect aneu- 
rism or a degenerated state of the arterial system. 

Occasionally, during sea-bathing, the hair falls off, the 
process of digestion becomes impaired and sleeplessness is 
experienced ; and this, no doubt, arises from the process of 
tissue destruction not being thoroughly balanced by repair. 

1 [Given by Wilson in his " Handbook of Hygiene," Am. ed., 
Philada., 1877, pp. 141-142.] 



WATER. 179 

As regards the external uses of cold water in medical 
practice, we may refer to the beneficial action of water- 
dressing and irrigation in surgery, to cold affusion in laryn- 
gismus stridulus, cholera, hysteria, the stupor of fevers and 
drunkenness, and, most of all, to the wonderful refrigerant 
action of cold baths in cases of abnormally high tempera- 
tures. 

It is generally held that a fatal result almost inevitably 
occurs in any case where the bodily temperature remains 
above 107° for several days at a time, and until very re- 
cently we were powerless to check the destructive influence 
of this complication. Within the last few years, however, 
Dr. Wilson Fox and others have shown that we may safely 
and effectually bring down this excessive heat in rheu- 
matism, where it principally occurs, by placing the patient 
in a bath at 95° and gradually adding cold water or ice 
until 60° Fahr. is reached. In this way a reduction of 
from seven to twelve degrees may be readily effected, but 
we must remember one practical point, that the patient's 
temperature continues to fall, as much even as six degrees, 
for forty or fifty minutes after he has been removed to bed. 
Four or five baths may be required during the first day of 
treatment, the patient remaining immersed during twenty or 
thirty minutes. There can be no doubt that by watching 
our cases of rheumatism carefully, and adopting this mode 
of treatment whenever the thermometer registers more than 
105° Fahr., we may save many lives. We may remember 
that the lowering effect is in inverse proportion to the weight 
of the body, and that the best effects are produced at the 
time when the temperature has a tendency to sink sponta- 
neously, as from 7 in the evening till morning, and again 
from 11 to 2 in mid-day. Beware of collapse, which is no 
is no imaginary danger, and must be met by stimulants. 

The Germans use the cold bath very freely in all febrile 
disorders, Liebermeister keeping his bad cases immersed for 
even two hours, and their success in diminishing the death- 
rate seems to be considerable. Much variety of opinion 
exists on the subject in this country, and a discussion at 
the Medical Society of London on cold bathing in enteric 
fever may be read with profit {vide "Transactions," vol. vii.), 
and from it we may come to the conclusion that no very 
marked influence on mortality has been produced by system- 
atic cold bathing, but that metabolism may be diminished, 



180 WATER. 

and some of the more characteristic symptoms of the ty- 
phoid state lessened in severity. Broadent's rule seems a 
good one — to use cold sponging when the temperature 
reaches 102°, and not begin the bath until the thermometer 
records 104°. 

Cold packing is an excellent stimulant to the skin ; it is 
useful as a less effectual but more agreeable mode of using 
antipyretic-treatment, and is of service in acute eruptive dis- 
orders, when the rash recedes. 

Warm water is also very serviceable, and we may mention 
the soothing action of warm fomentation, the warm douche 
in early joint disease, and the use of the warm bath in the 
convulsive diseases of children, for the relief of colic spas- 
modic stricture, hernia, gall or renal calculi, and in cases of 
extensive burns or moist skin diseases, employed after the 
manner of Hebra, whose patients frequently remain in a state 
of continuous soaking for days together. 

Ice is a most valuable application for relieving pain and 
checking inflammation in orchitis, bubo, meningitis, etc., as 
well as for the arrest of hemorrhage, and to allay thirst and 
obstinate vomiting; and introduced into the rectum it pro- 
duces some antipyretic effect. 

Vapor is often used as a soothing and relaxing application 
in tonsillitis, bronchitis, croup, etc.; and, in the form of 
bath, it favors diaphoresis. 

Constitutional Action. 

When water is taken internally, it acts in some measure 
as a purgative by supplying moisture to the feces; it pro- 
motes digestion by stimulating the secretion of gastric juice 
and aiding the passage of peptones into the blood (Ringer); 
and it is in some measure a diuretic, increasing temporarily 
the excretion of chloride of sodium, and more permanently 
the elimination of urea, phosphoric and sulphuric acids by 
the urine. It is, of course, the universal solvent, and its 
importance in the animal economy is shown by the fact that 
it constitutes about sixty-eight of the hundred parts which 
build up our entire bodily frame, and that five pints are 
given out from the body of one average-sized adult in the 
twenty-four hours. The urgent necessity for its purity is 
further proved by the leading part it has always taken in the 
spread of epidemics ; for not only cholera, but also enteric 
fever, has thus been largely propagated, whilst entozoa are 



WATER. 181 

thus introduced into the system, and the presence of other 
impurities may give rise to dysentery, diarrhoea, goitre and 
yellow fever. [The most dangerous adulteration of drinking 
water is that occasioned by the presence of decaying organic 
or albuminoid matter. During epidemics of bowel affections, 
all water should be boiled previous to drinking.] Specific 
adulterations also, like lead, have frequently occasioned very 
painful and even fatal attacks of illness. 

But we derive great benefit in practice from the use of 
some of those very impure waters, highly impregnated with 
various mineral ingredients, which are known as mineral 
waters, and which are met with in such profusion and variety 
both at home and abroad. Fashion, no less than undoubted 
success attending their use, has now brought these natu- 
rally adulterated waters prominently forward, and it is very 
essential that every practitioner should have some knowledge 
of their chief constituents and the principal health resorts 
where they can be partaken of in greatest perfection. Our 
present limits, however, will only permit a very bare enume- 
ration of the principal classes into which mineral waters have 
been divided. 

1st. We have the chalybeate or ferruginous class, which 
contains iron in varying proportion, in the form either of 
carbonate held in solution by carbonate acid gas, as at [Ex- 
celsior Rock Spring, Saratoga] Spa, Tunbridge Wells, and 
Harrowgate ; or of sulphate, as at [Bedford Springs, Pa., 
Fairmount Park, Phila.] Brighton, Isle of Wight, etc. Some 
are hot and some cold, and some, as Monte Dore, contain a 
minute quantity of arsenious acid. Whilst we generally 
find them well borne as carbonate, we must be cautious of 
their use in very plethoric and full-blooded patients. They 
are very useful in cases of anaemia, chlorosis, struma, and 
other conditions of debility. 

2d. Acidulous or carbonated. These are agreeable and 
sparkling, holding in solution carbonates of lime, soda, and 
magnesia. They are met with at [Gettysburg] Seltzer, and 
Carlsbad, and are serviceable in gout and dyspepsia. 

3d. Saline, some of which are purgative by containing the 
sulphates of magnesia and soda, as at [Saratoga, Empire 
Spring] Cheltenham, Leamington, Friedrichshall, etc. ; 
others, as Buxton, Bath, and Bristol, are impregnated with 
carbonate and sulphate of lime ; others with chlorides, as 
Wiesbaden, Baden-Baden ; a fourth class contain iodine and 
16 



182 MEDICATED WATERS — CHLORINE WATER. 

bromine in combination with sodium and magnesium, as at 
Homburg, Kissingen, "Woodhall, etc. ; whilst a fifth class, as 
at Vichy, Ems, Apollinaris and Hunyadi Janos, owe their 
properties to the alkaline carbonates which they contain. 

4th. Sulphuretted or hepatic waters contain sulphuretted 
hydrogen in solution, and possess a very offensive taste and 
smell. They are generally thermal, frequently having a 
high temperature. They are chiefly met with at Harrowgate, 
Moffat, Cheltenhham, Aix-la-Chapelle [Virginia Sulphur 
Springs], Bareges, Eaux Bonnes, etc., and are principally 
used in chronic skin diseases, in chronic rheumatism and 
bronchitis, in advanced syphilis, and for the elimination of 
mercury from the system. Those patients who are unable 
to visit the different spas at home or abroad may drink the 
bottled waters, or we may manufacture rough imitations by 
combination of the various ingredients. In prescribing saline 
purgatives, we should always remember the principle of very 
free dilution and frequently repeated small dose on an empty 
stomach ; but, although we may often do great good by this 
mode of administration, we miss the change of air and scene, 
the early and regular hours, the simple diet, and the especial 
faith and mental anticipation with which the chronic rheu- 
matic and dyspeptic approach the health resort of their choice. 



[Aquae. 

The class of Medicated Waters in the U. S. Pharma- 
copoeia includes the following : — 

Aqua Ammonise Aqua Cirmamoini 

" Ammonise Fortior " Creasoti 

" Amygdala? Aniarae " Destillata 

" Anisi " Foeniculi 

" Anrantii Florum " Mentha? Piperita 

" Camphora? " Mentha? Viridis 

" Chlori " Rosa?.] 



[AQUA CHLORI— CHLORINE WATER. 

An aqueous solution of Chlorine {CI : 35.4), containing at least QAper 
cent, of the gas. 

Dose, largely diluted, f3j-iv (4- to 16. Gm.). 
A greenish-yellow clear liquid having the suffocating odor 
and disagreeable taste of Chlorine. Used externally as a 



CHLORINE WATER. 



183 



disinfectant. Watson recommended an extemporaneous 
chlorine solution to be used in diphtheria.] 

The use of chlorine is almost entirely confined to its ex 
ternal application. 



Physiological Action. 

1. Concentrated chlorine 
gas directed upon the skin 
causes redness and smarting, 
followed by a pustular erup- 
tion and even erysipelatous 
inflammation. 

2. It is an excellent disin- 
fectant, decomposing sulphu- 
retted hydrogen and ammo- 
nium sulphide at once and 
more effectually than any 
other gas, and also destroys 
organic matter in the air, as 
it bleaches organic pigments 
and destroys odors, either by 
abstracting hydrogen or by 
oxidation. 

3. The inhalation of chlo- 
rine gas is stimulating or 
irritating to the lungs. 



Therapeutical Action. 

1. It is never, however, 
used as a counter-irritant. 



2. It is therefore exten- 
sively used as given off by 
chloride of lime to purify the 
air from offensive effluvia, 
and to destroy infectious 
germs. In the form of lotion 
it is also used to cleanse foul 
or sloughing sores. 



3. It has therefore been 
used in some forms of chronic 
bronchitis and phthisis, but 
is not now much employed. 
[It may be used in strychnine- 
poisoning.'] 



Internal Use. 

Chlorine used to be given internally in medicine in various 
infectious fevers with a view to disinfection, but this has now 
become quite obsolete. [As extemporaneously made by the 
action of muriatic acid 5j> upon chlorate of potassium gr. x, 
to which a pint of water is added in successive portions, it 
is recommended by Watson and Flint for diphtheria and 
other zymotic diseases.] 

Dose and Mode op Administration. 

As a disinfectant chlorine is obtained by acting on chloride 
of lime with water or dilute sulphuric acid, or by pouring 



184 SILVER. 

four parts by weight of strong hydrochloric acid on one part 
of powdered binoxide of manganese, or mixing four parts of 
common salt and one of binoxide of manganese with two 
parts by weight of sulphuric acid and two of water, varying 
the quantities according to the size of the room. 

Vapor chlori [Br.] is used for inhalation, and liquor chlori 
[Br.] aqua chlori [U. S.] may be employed diluted as a 
lotion, or given internally. 

Disadvantage. 

The great drawback of chlorine is the very irritating 
nature of its vapor, rendering it unsuitable for general use 
in rooms actually inhabited by the sick. 



ARGENTUM— SILVER. 

[Officinal Salts, U. S. 

Argenti Cyanidum — for making Acidum Hydrocy- 
anicum Dilutum for immediate use. Dose, gr. ^q— sV («0016- 
.003 Gm.). 

Argenti Nitras. Dose, gr. £-J (.01 to .03 Gm.). 

Argenti Nitras Dilutus (Mitigated lunar caustic, 
equal parts of nitrates of silver and potassium) for external 
use. 

Argenti Nitras Fusus— Lunar caustic, for external 
use. 

Argenti Oxidum. Dose, gr. ss-ij (.03 to .12 Gm.), 
in pill. 

Argenti Iodidum. Dose, gr. ^-j (.008-.065 Gm.). 

Antidote. 

The chemical antidote to nitrate of silver is table salt, 
which should be followed by an emetic or a purgative. 

Metallic silver is inert. As it occasions no chemical irri- 
tation in the tissues, canulse are made of it for use in empyema 
to wash out the chest, etc., and silver wire is also used in 
surgery to unite the fractured ends of bones where there is 
delayed union, and for sutures in wounds of the scalp and 
elsewhere. The salts of silver are best administered in pill 
form, for which gum Arabic is probably the best excipient, 
as with vegetable extracts, or glucose, they are apt to ex- 
plode.] 



SILVER. 



185 



Local Action. 



Physiological. 

The nitrate of silver pri- 
marily hardens, but seconda- 
rily destroys, the cuticle, and 
condenses the tissues by co- 
agulating their albumen. 



Its application may cause 
ulceration of the healthy skin, 
and it is often used to check 
the activity of granulating 
surfaces. A convenient form 
is the argenti nitras dilutus 



used as pencils. 



Therapeutical. 

Nitrate of silver, either in 
substance or solution, lias 
been used to check the spread 
of erysipelatous inflamma- 
tion ; to arrest the pitting of 
smallpox ; and to avert the 
formation of bed-sores. 

It is a good injection for 
gonorrhoea, or collyrium for 
conjunctivitis, and a strong 
solution is one of our best 
remedies for various relaxed 
or ulcerated conditions of the 
fauces. In substance, lunar 
caustic forms a good applica- 
tion to simple venereal sores, 
ulcerated tonsils, or to any 
ulcerating or granulating tis- 
sue, when we wish to repress 
exuberant granulations or ex- 
cite a new and more healthy 
action. 



Internal Actions and Uses. 

Silver is now but little employed internally. It formerly 
enjoyed a great reputation in the treatment of nervous dis- 
orders ; and Erb and Seguin hold it to be of great value in 
the earlier stages of locomotor ataxy. I am, however, quite 
convinced, from my own observation, that it is sometimes 
useful in epilepsy, more especially as replacing bromide of 
potassium, when that valuable remedy has temporarily lost 
its power over the disease. 

And, again, it seems to be the only curative agent in some 
peculiarly severe cases of gastralgia, patients occasionally 
willingly running the risk of disfigurement in the hope of 
cure. In prescribing it, we must never forget its power of 
causing an indelible and most unsightly greyish-blue discolora- 
tion of the skin, seldom appearing, however, before the salt 
has been used for three months. 

10* 



186 ARNICA FLOWERS — ARNICA ROOT. 

[Pepper has used the nitrate of silver in the treatment of 
typhoid fever with excellent results in controlling diarrhoea, 
relieving irritation, and possibly preventing hemorrhage. 
The remedy (gr. \ to ^) is given in mucilage of acacia, three 
or four times daily; and if the bowels are constipated ex- 
tract of belladonna is combined with it ; if there is much 
looseness a few drops of deodorized tincture of opium are 
added.] 1 



ARNICA FLORES— ARNICA FLOWERS. 

[ The flower heads of Arnica Montana, Linn4 (N. 0. Compositce) .] 



ARNIC^E RADIX—ARNICA ROOT. 

[ The rhizome and rootlets of Arnica Montana. 

Officinal Preparations, U. S. 
From the flowers. 

Tinetura Arniese Florum. (20 per cent.) Dose, 
gU. x-xxx (.65 to 2 Gin.), well diluted. 
From the root. 

Extraetum Arnicas Radicis. Dose, gr. j-iij (.06 
to .20 Gm.). 

Extraetum Arnicas Radicis Fluidum. Dose, 
ttt^v to xx (.32-1.30 Gm.). 

Tinetura Arnicas Radicis. (10 per cent.) Dose, 
nrv-x (.32-65 Gm.). 

Emplastrum Arnicas (Ext. arnicae radicis and em- 
plast. plumbi, 2 parts).] 

External Actions. 
If applied to the skin for Some practitioners value 
some time, arnica causes red- arnica highly for the power 
ness and irritation, and in which they believe it to pos- 
some susceptible subjects sess of absorbing bruises and 
most violent erysipelatous relieving sprains. Dr. Gar- 
inflammation, even ending in rod, on the other hand, as- 
death, has resulted. It must serts that anj T power it seems 
therefore be used with cau- to exercise in dispersing ex- 
tion. travasations of blood is sim- 

ply due to the spirit which 

1 [Proceedings of the Philadelphia County Medical Society, vol. 
iii. p. 51.] 



ARNICA ROOT. 



187 



the tincture contains. Dr. 
Phillips, again, tells us that 
the irritating effects never 
follow the use of an aqueous 
solution, which contains none 
of the arnicine or volatile oil. 



Physiological. 

[Roberts Bartholow sums 
up its action as follows : In- 
creases flow of saliva ; causes 
nausea and vomiting; even 
irritant poisoning may result ; 
it increases secretion from 
mucous membranes. It rap- 
idly diffuses into the blood, 
and in small doses acts as a 
stimulant, increasing the ac- 
tion of the heart, producing a 
general feeling of warmth 
throughout the body ; it in- 
creases the secretion of the 
kidneys and the sweat glands. 
In larger doses the stimulat- 
ing effect is shorter in du- 
ration, and is followed by 
vomiting, depression, or col- 
lapse. Death is caused by 
arrest of action of the heart.] 

Poisoning. 

[Poisonous doses cause dilated pupils, pain in the head, 
and stupor due to accumulation of carbonic acid in the blood. 
Atropine is the physiological antidote.] 

Internal Actions. 

The physiological and medicinal actions of arnica can only 
be balanced with difficulty, as the evidence regarding the 
former is very conflicting, and the opinions on the latter cer- 
tainly err in the direction of over-confidence. As it is rarely, 
if ever, used as a medicinal agent save by homoeopathic 
practitioners, it does not seem necessary to say more about 
its asserted virtues. 



Therapeutical. 

[Arnica has not been used 
much internally, but recent in- 
vestigations show that it may 
well be employed as a cardiac 
stimulant in low grades of fe- 
ver, in small doses, frequently 
repeated. In order to de- 
press the temperature and ac- 
tion of the heart larger doses 
will be required. In delirium 
tremens, where restlessness is 
due to debility, small doses 
may be used ; in mania, with 
high arterial excitement, 
large doses will be called for. 
It has also been recommended 
in a similar mode of employ- 
ment in acute rheumatism 
and rheumatoid arthritis.] 



188 



ASAFETIDA 



ASAFOETIDA— ASAFETIDA. 

[A gum-resin, obtained from the root of Ferula Narthex, and Ferula 
Scorodosma (N. 0. Umbelliferoz) . 

Officinal Preparations, U. S. 

Mistura Asafcetidee (4 per cent.). Milk of Asafetida. 
Dose, f |ss-j (16 to 32 Gm.). 

Mistura Magnesias et Asafcetida? (Dewees's Carmi- 
native). (Tr. Opii deod. 1 per cent.) Dose, 3 ss ~j (2. to 
4. Gm.). 

Tinetura Asafcetidffi (20 per cent.). Dose, f3ss-j (2 
to 4 Gm.). 

Pilule Asafcetidffi (each gr. iij). Dose, 2 to 4. 

Pilulffi Aloes et Asafcetida? (each gr. j^). 

Pilule Galbani Composite (asafetida gr. A). 

Emplastrum Asafcetid® (35 per cent, asafetida).] 



Physiological Action. 

A good deal of digestive 
disturbance seems to follow 
the administration of this 
drug to healthy persons ; but 
the evidence is too conflicting 
to enable us to lay down any 
exact scheme of its influence 
on the various functions of 
the body. 



Therapeutical. 

Asafoetida has been used 
and recommended in a con- 
siderable variety of affections, 
but practically it is now only 
prescribed in flatulent dys- 
pepsia and in hysteria, where 
its excessively nauseous smell 
and taste are supposed to give 
it an advantage over other 
drugs of the same class. 

Horatio C. Wood states 
that " asafetida is one of the 
most efficient of the so-called 
antispasmodics, and may be 
given to fulfil the same in- 
dications as valerian in func- 
tional spasm, in hysteria, and 
nervousness. It differs from 
valerian in having a much 
more decided action upon the 
mucous membranes. It is an 
excellent carminative, and in 
the form of injection is con- 



ASCLEPIAS — ASPIDIUM. 189 

stantly used for the relief of 
tympanites. It also in small 
doses increases the appetite 
and affords relief in dyspepsia, 
with flatulent colic and cos- 
tiveness, of the aged or hysteri- 
cal. As a stimulating expec- 
torant and antispasmodic, it 
is useful in whooping-cough 
and chronic catarrh. It is 
especially efficient in pallia- 
ting the latter affection as 
occurring in old people, when 
the difficulty of breathing is 
paroxysmally increased by 
spasm of the bronchial tubes. 
In infantile convulsions and in 
severe infantile colic, asafet- 
ida enemata (3ij to ,|ij of 
the milk) are exceedingly 
useful and harmless." — The- 
rapeutics.~\ 



[ASCLEPIAS— ASCLEPIAS (PLEURISY-ROOT). 

The root of Asclepias tuberosa, Linne (N. 0. Asclepiadacece) . 

Contains resinous and fatty matter. In small doses in- 
creases action of skin and kidneys, in large doses is emetic 
and purgative. It has some reputation for expectorant 
qualities, and it depresses the heart's action. Dose a half 
drachm to a drachm in infusion.] 



ASPIDIUM— ASPIDIUM (MALE FERN U. S. 1870). 

[The rhizome of Aspidium Filix Mas, Swartz, and of Aspidiurn marginale, 
Willdenow (N. 0. Filices). 

Officinal Preparation. 

Oleoresina Aspidii. Dose, n^xxx-5j (2. to 4. 
Gm.]. 

Local Action. 
Fern oil has no local action. 



190 



ATROPINE — BITTER ORANGE PEEL. 



Constitutional Action. 



Physiological Action. 

The only marked action of 
the male fern is that of killing 
tape-worms. It occasionally 
produces a little nausea and 
diarrhoea, but in most cases 
it can be taken without dis- 
comfort. [Its virtue resides 
in an oleoresin, which is the 
officinal title in the U. S. P., 
but which is termed a fluid 
extract in the Ph. Br. ; it is 
also sometimes spoken of 
simply as oil of male fern.] 



Therapeutical. 

Fern-oil is used in medi- 
cine purely as an anthelmin- 
tic. Its destructive influence 
over all varieties of taeniae 
has been effectually proved 
by a great mass of evidence, 
and one or two doses gene- 
rally succeed in dislodging 
the entire worm. It is essen- 
tial that the draught should 
be taken on an empty sto- 
mach, and, the intestines 
having been first cleared by 
a purgative, we direct our 
patient to fast for a few hours 
before bedtime, when he is 
advised to take a drachm of 
the liquid extract [oleoresin] 
suspended in milk. Or we 
may avail ourselves of the 
following formula, which acts 
well in concealing the nause- 
ous flavor of the drug : — 



$ 



Oleoresinse filicis f 5iss ; or 6 

Mucilaginis tragacanthse f §ss ; " 16 

Syrupi zingiberis f ^ij ; 8 

Aquse q. s. ad f^iss; " 48 

Misce, fiat haustus nocte vel primo mane suinendus 



Gm. 



ATROPINA— ATROPINE. 

ATROPINE SULPHAS— SULPHATE OF 
ATROPINE. 
(See Belladonna.) 



AURANTII AMARI CORTEX— BITTER ORANGE 
PEEL. 

[ The rind of the fruit of Citrus vulgaris. Risso (iV. 0. Aurantiacece) . J 



SWEET ORANGE PEEL — ORANGE FLOWERS. 191 



AURANTII DULCIS CORTEX— SWEET ORANGE 
PEEL. 

[ The rind of the fruit of Citrus aurantium (N. 0. Aurantiacece) .] 



AURANTII FLORES— ORANGE FLOWERS. 

[ The partly expanded fresh flowers of Citrus aurantium and Citrus vulgaris 
(JV. 0. Aurantiaceoz) . 



Officinal Preparations, U. S. 

Extractum Aurantii Amari Fluidum (for flavor- 
ing). 

Tinetura Aurantii Amari (20 per cent.). Used for 
flavoring. 

Aqua Aurantii Florum. Used as a vehicle. 

Syrupus Aurantii Florum. Used as a vehicle. 

Oleum Aurantii Florum. (Enters into Spiritus 
Odoratus.) 

Elixir Aurantii. Simple elixir. Used as a vehicle. 

Oleum Aurantii Cortieis. 

Syrupus Aurantii. Used as a vehicle. 

Tinetura Aurantii Duleis (20 per cent.). Dose, 
f3j-ij (4. to 8. Gm.). 

Spiritus Aurantii. (Oil of orange peel 6, alcohol 
94 pts,)] 

Properties. 

The various preparations of orange require no detailed 
comment, for beyond the fact that those made from the rind 
are mildly tonic in virtue of their bitterness, and that the 
syrup and the orange-flower water are agreeable flavoring 
additions to a prescription, we have no evidence of their 
special therapeutic properties, if any exist. [The volatile 
oil of the flowers, obtained by distillation, is called, in com- 
merce, oil of Neroli,and orange-flower water is hence some- 
times termed Neroli water. Orange peel enters into the 
popular compound tincture of cinchona (Huxham's tincture) 
and the compound tincture of gentian.] 



192 



CHLORIDE OF GOLD AND SODIUM. 



[AURI ET SODII CHLORIDUM— CHLORIDE OF 
GOLD AND SODIUM. 

A mixture of equal parts of dry chloride of gold and chloride of sodium 
{corresponding with 32.4 per cent, of metallic gold). 

Dose, gr. 5 \ to ^ (- 001 to - 002 Gm.). 

Local Effects. 
In concentrated form the chloride of gold is escharotic. 



Constitutional Effects. 

The effects of the chloride of gold resemble those of the 
corrosive chloride of mercury ; in overdoses corrosive poison- 
ing is produced ; the symptoms, closely assimilating those of 
the mercurial, call for the same remedial measures. 



Physiological Effects. 

Digestive Tract. — In over- 
doses gastro-enteritis is set 
up ; in minute continued 
doses, the gold salts act as 
stimulants to the glandular 
structures of the stomach and 
liver. 



Circulation. — Like mer- 
cury, the chloride of gold re- 
duces the oxidizing power of 
the red blood cells, and in- 
creases tissue waste. In small 
doses it stimulates the func- 
tions of nutrition, and in- 
creases assimilation. 

Nervous System In small 

doses the mental functions 
are quickened (Bartholow), 
but upon the spinal cord es- 
pecially are its effects seen 
to be those of a decided 
stimulant. 



Therapeutical. 

In dyspepsia, gold is use- 
ful in the same class of cases 
as are benefited by the nitrate 
of silver. In the early stages 
of cirrhosis of the liver the 
chloride of gold and sodium 
is one of the most efficient 
remedies we possess. (Bar- 
tholow.) 

In fibroid disease of other 
organs, such as the kidney, 
it is useful, especially in that 
form of Bright's disease cha- 
racterized by a large amount 
of pale urine, containing but a 
small amount of albumen. 

In premature senility or 
decay of the mental powers, 
gold may be cautiously used 
with benefit; also in the dif- 
ferent forms of sclerosis of 
the spinal cord in its early 
stages. 



AZEDARACH — BALSAM OF PERU. 193 

Sexual System. — Thegeni- In the treatment of defec- 

tal organs are stimulated five menstruation, and si mi- 
through an action upon the lar disorders dependent upon 
spinal cord. want of sufficient innervation, 

the gold salts have gained 
some reputation. 

In tertiary syphilis the chloride of gold and sodium has 
been found to be an efficient substitute for mercuric chloride.] 



[AZEDARACLL—AZEDARACH. 

( The bark of the root of Melia Azedarach, Linne (N. 0. Meliaceoz). 

Following the administration of very large doses of the 
decoction, vertigo, dilated pupils, stertorous respiration and 
stupor sometimes occur. It generally causes vomiting and 
purging, and is an effective agent for destroying intestinal 
worms (lumbricoids, etc.). A fluid extract and a syrup have 
been used, but a decoction of the fresh bark (4 ozs. to a quart 
boiled down to a pint) is preferred, given in tablespoonful 
doses every two or three hours, to a child, until it purges.] 



BALSAMUM PERUVIANUM— BALSAM OF PERU. 

[_A balsam obtained from Myroxylon Peruiferum (iV. 0. Leguminosai, 
Papilionaceos). 

Dose, f3ss (2 Gm.) in emulsion.] 

Local Action. 

Peruvian balsam tends to It may therefore be used, 

check copious and unhealthy like myrrh, as an application 

secretions. [It has decided to foul and unhealthy sores, 
antiseptic properties.] 

Constitutional Action. 

Like the other gum bal- It has therefore been pre- 
sams, it acts on the mucous scribed to restrain excessive 
membranes, and more espe- discharges in bronchitis, etc. 
cially on the bronchial tubes. [It may be employed by in- 
halation with steam, or from 
an atomizer, in phthisis with 
benefit.] 
17 



194 BALSAM OF TOLU — BELLADONNA ROOT, 



BALSAMUM TOLUTANUM— BALSAM OF TOLU. 

[A balsam obtained from Myroxylon Toluiferm, Kunth (N. O. Legumi- 
nosce, Papilionaceoi). 

Officinal Preparations, U. S. 

Tinetura Tolutana (10 per cent.). Dose, f"3j (4. 
Gm.). 

Syrupus Tolutamis. (Tinct. fjij to Oj.) Dose, 
f^ss-j (16. to 32. Gm.). 

The Tinetura Benzoini Composita contains of Balsam of 
Tolu Jj^ in each pint.] 

This agreeable preparation is almost exclusively used as a 
flavoring addition to cough mixtures, in the form of the syrup. 



BELLADONNA FOLIA—BELLADONNA LEAVES. 

[The leaves of Atropa Belladonna, Linne (N. 0. Solanaceoz) .] 



BELLADONNA RADIX—BELLADONNA ROOT. 

[ The root of Atropa Belladonna (N. O. Solanaceai). 

Officinal Preparations, U. S. 

From the leaves : — 

Extraetum Belladonna? Alcoholieum. Dose, 
gr. J-ij (.016 to .13 Gm.). 

Tinetura Belladonna? (15 per cent.). Dose, gtt. 
x-xx (.65 to 1.30 Gm.). 

Unguentum Belladonna?. (Alcoholic extract, 10 
per ct.) 

From the root : — 

Extraetum Belladonna? Fluidum. Dose, rr^ij 
(.13 Gm.). 

Emplastrum Belladonna?. (Representing 100 per 
cent, of the root.) 

Abstractum Belladonna?. Dose, gr. i-j (03.-06 
Gm.). 

Linimentum Belladonnas. (Fl. ext, 95, camphor 
5 parts.) 



BELLADONNA. 195 

Atrophia. i Dose gr. ^ or, hypodermically, 

Atropinae Sulphas, |gr. T J^ (.001 to .0005 Gm.). 

Antidotes. 

Chemical. Fresh animal charcoal, tannin, vegetable as- 
tringents and the fixed alkalies. 

Physiological. Opium, Calabar bean, tartrate of anti- 
mony and potassium, and pilocarpine. 

In the treatment of belladonna-poisoning, the irritating 
emetics, such as mustard, ipecacuanha, and sulphate of zinc, 
should be exhibited to remove from the stomach any excess 
of the poison remaining unabsorbed. Apomorphine might 
be useful hypodermically (gr. ^L, repeated). Purgatives 
containing; the chemical antidotes should then be given to 
neutralize any of the drug in the intestines. Symptoms of 
exhaustion should be treated as they arise, by artificial 
respiration, douches, counter-irritants, and diffusive stimu- 
lants. The physiological antidotes, be.ng counter-poisons, 
should be used with the greatest care.] 

Local Action. 

Belladonna is used externally, on account of its soothing 
properties, in various forms of neuralgic and rheumatic 
pains, in which cases the liniment, applied either alone, or 
in combination with chloroform liniment, often gives relief. 
It is also a good application in acute rheumatism, placed on 
cotton- wool, and thus encasing the swollen and tender joints. 
Belladonna is also useful, as has been specially pointed out 
by Mr. Heath, in boils and abscesses, where the suppurative 
process ma\ be prevented or even arrested by its use. It is 
also a good application to inflamed piles and fissure of the 
rectum. It is also applied to the skin to check localized 
sweating, to the breast to arrest the secretion of milk, and 
to the neighborhood of the eye to dilate the pupil ; but its 
actions here are so intimately associated with the theory of 
its internal administration that we will say no more on the 
subject at present. 

Belladonna is very readily absorbed through the unbroken 
cuticle, and symptoms of poisoning have occasionally been 
caused by its local application. 



BELLADONNA. 



Internal Administration. 



Physiological Action. 

1. On the Brain After 

full doses of belladonna, a 
tendency to delirium sets in, 
usually of a joyful character, 
and attended by hallucina- 
tions and spectral illusions. 
Sleep generally follows. 

2. On the Spinal Cord. — 
In frogs this action is very 
decided, for when atropine is 
injected below the skin the 
animal is at first paralyzed, 
lying quite motionless, with 
arrested breathing, which 
period of inaction is suddenly 
interrupted in about from one 
to eighteen hours by the oc- 
currence of violent tetanic 
spasms. 

3. Belladonna paralyzes 
the terminal filaments of the 
third nerve applied to the 
circular or sphincter fibres of 
the iris, and thus allows the 
sympathetic, which rules over 
the radiating fibres, to come 
into unchecked play, and so 
dilate the pupil. At the 
same time we observe a di- 
minution in ocular tension 
and imperfect vision, espe- 
cially for near objects, due to 
paralysis of the power of ac- 
commodation. 

Gubler says that it also 
causes a diminished sensi- 
bility of the cornea and 
retina, with prolonged reten- 
tion of images by the retina. 



Therapeutical Action. 

1. Belladonna may be 
cautiously used as a hypnotic 
when other remedies fail. 
Ringer records an interesting 
case of acute mania in which 
the heroic dose of gr. j of 
atropine acted well by causing 
sleep. 

2. It is used in some spinal 
affections in accordance with 
the principles of Dr. Brown- 
Sequard, explained under an- 
other section. 

It is also of value in check- 
ing the tendency which occa- 
sionally exists to nocturnal 
seminal emissions, when these 
become of exhausting fre- 
quency. 

3. Belladonna, used more 
conveniently in the cleaner 
form of atropine, is in very 
extensive use in eye diseases 
to facilitate ophthalmoscopic 
examinations, and to keep the 
pupil freely dilated in iritis, 
and so lessen the risk of ad- 
hesion of its free margin to 
the lens, with subsequent 
contraction, distortion, and 
impairment of vision. 

It is also used to obviate 
protrusion of the iris through 
any hole in the cornea made 
by ulceration or accident, 
and it forms a soothing ap- 
plication to various painful 
affections. 

To dilate the pupil the liq. 



BELLADONNA. 



197 



He is rather inclined to be- 
lieve that it has some special 
action on the muscular tissue 
of the iris. 

The strong solution of the 
Br. P. must be used with cau- 
tion, as acute glaucoma has 
undoubtedly followed its free 
application to the eye. Be 
careful to use perfectly fresh 
solutions, as fungi rapidly 
form, and may cause trouble- 
some irritation, and the 
liq. atropine sulph. [Br. P.] 
is a more stable preparation 
than the liq. atropines [Br. 
P.] which is irritating be- 
cause of the spirit which it 
contains. 



4. The action of bella- 
donna on the sympathetic 
nervous system is somewhat 
irregular, and to this is no 
doubt due some at least of 
that action on certain secre- 
tions which we shall shortly 
note more fully. But one 
symptom often observed, 
more especially in children, 
probably proceeds from vaso- 
motor paralysis, and that is 
transient flushing and sweat- 
It 



atropinoe sulph. [Br., gr. i v ad 
fjj] is now generally used, 
care being taken only to intro- 
duce a very small drop into 
the eye ; for if a larger quan- 
tity is applied, the resulting 
effects and inconveniences, 
more especially the paralysis 
of accommodation, spoiling 
the eye for near work, may 
last from a week to twelve 
days, much to the annoyance 
of the patient. [Although 
weaker solutions take a little 
longer time to dilate the pupil 
and paralyze the accommoda- 
tion, yet these effects are more 
transient and therefore more 
satisfactory to the patient. 
A gr. ^ solution is strong 
enough for ordinary use, and 
will dilate the pupil in about 
half an hour after instilla- 
tion.] 

Belladonna being so read- 
ily absorbed, however, dila- 
tation of the pupil will ensue 
on application of the extract 
or liniment for any length of 
time to any part of the body. 

4. When we wish rapid 
and transient dilatation of the 
pupil, without complete re- 
laxation of the ciliary muscle, 
we should use homatropine in 
preference to atropine. [Co- 
caine, in 2 to 4 per cent, so- 
lution, is still better, because 
the dilatation does not last 
more than a few hours, while 
with homatropine it may last 
one or two days.] 



198 



BELLADONNA 



ing of the face now and then 
following a dose. 

5. The influence of bella- 
donna on the circulation is 
due to another nervous influ- 
ence. Under the use of this 
drug we observe increased 
rapidity and force of cardiac 
action, and this is explained 
by a paralyzing action which 
it exerts on the terminal in- 
hibitory filaments of the 
pneumogastric nerve distri- 
buted to the intimate struc- 
ture of the heart, as well as 
on the nerve itself, thus dif- 
fering from curare, which 
only affects the trunk of the 
nerve. It is proved by ex- 
periment that the sympathetic 
nerve supply has the power 
of causing very rapid action 
of the heart; but a rein is 
kept on this, and the proper 
balance of motive force is 
sustained by the pneumogas- 
tric nerve, which inhibits or 
restrains the impetuous action 
of the sympathetic. By 
paralyzing these inhibitory 
filaments, then, belladonna 
hands the heart over to the 
sympathetic, which, without 
rein or drag, runs riot, and 
we accordingly find that ex- 
cessive increase in the heart's 
rapidity follows the injection 
of a moderate quantity of 
atropine. 

Coincident with this we 
get raised arterial tension. 

6. Belladonna contracts 
the small vessels, probably 



5. Belladonna is an excel- 
lent cardiac tonic, increasing 
the regularity and strength 
of the contractions of the 
heart, more especially in fail- 
ure of compensation in cases 
of mitral regurgitation. It 
is good practice to combine it 
with digitalis. 

It is also a very soothing 
remedy in cases of irritable 
palpitation, and the old- 
fashioned belladonna plaster 
is certainly of use in these 
conditions. 



6. Dr. Brown-Sequard re- 
commends the use of bella- 



BELLADONNA. 



199 



not from nervous influence, 
but from a direct action upon 
the unstriped muscular fibres 
surrounding the arterioles. 



7. On Respiration. — Bel- 
ladonna tends to increase the 
rapidity of the breathing by 
stimulation of the respiratory 
centre. 

8. It has the power of con- 
tracting unstriped muscular 
fibre in other situations than 
the arterial tubes. It pro- 
bably does so both in the 
bladder and intestines, and it 
should be remembered that 
in cases where the expulsive 
power of the bladder is natu- 
rally weak, complete reten- 
tion of urine may be produced 
by its administration. 



donna in those cases of chro- 
nic inflammation of the spine 
leading to paralysis, where it 
acts well by contracting the 
vessels and diminishing the 
supply of blood to the affected 
part ; and he gives it. inter- 
nally, and applies a plaster 
along the spine. 

To this contracting influ- 
ence on the small vessels is 
probably due the effect of 
belladonna in checking local 
inflammatory conditions; 
[and the power of atropine 
given in small dozes fre- 
quently repeated, to relieve 
menorrhagia and hcemo'pty- 
sis.~\ 

7. . Atropine has been re- 
commended as an efficient 
remedy in asthma. 



8. Belladonna is an excel- 
lent remedy for the nocturnal 
incontinence of urine of chil- 
dren ; but in order to do any 
good it must be boldly pushed, 
and I have been obliged to 
give as much as f 3jss or even 
f'5ij of the tincture [Ph. 
B., which is one-half the 
strength of that of the U. S. 
P.] before success was at- 
tained. 

From its tonic influence on 
the muscular structures of the 
intestines it is an excellent 
adjunct to purgative pill- 
masses, from i to ^ grain act- 
ing well in combination with 
colocynth ; or, even given 



200 



BELLADONNA. 



Action on Secretion — 9. 
Salivary It checks the sa- 
livary secretion, causing a 
peculiar sensation of dryness 
in the mouth and throat; and 
this is believed to be due to 
a remarkable selective action 
on the secretory branches 
supplied from the chorda tym- 
pani nerve to the submaxil- 
lary ganglion. 

10. Cutaneous. — Bella- 
donna most effectually arrests 
the action of the skin, and 
occasionally under its use a 
vivid red eruption, not unlike 
scarlet fever, breaks out. 

Its anhidrotic action is ex- 
plained by its paralyzing the 
ends of the nerves supplying 
the sweat-glands. 



11. It also checks the se- 
cretion of the milk, used 
either locally or by internal 
use, and this is probably due 
to a paralyzing effect on the 
lacteal nerves. 



alone with ext. of gentian, it 
will often secure a regular 
action of the bowels. 

It is also very useful by 
relieving spasm, as in colic, 
and intestinal obstruction has 
occasionally yielded to large 
doses. 

9. Belladonna has been 
used to check excessive sali- 
vation. 



10. It is an excellent rem- 
edy for undue sweating, 
whether general, as in phthisis 
as originally recommended 
by Bartholow and Da Costa 
or in rheumatism ; or local, 
as about the head of rickety 
children or the feet of some 
individuals. It may be either 
given in the form of succus, 
extract, or tincture, or better 
by the subcutaneous injection 
of atropine. 

11. It is a most valuable 
remedy in cases where in- 
flammation threatens in a 
breast, when the child has 
died or cannot suck, and the 
gland becomes congested 
from retention of its secre- 
tion. Here the external 
application of belladonna 
speedily diminishes the red, 
tense, shining aspect, relieves 



BELLADONNA. 201 

the wearing pain, and arrests 

the milk. 
12. On the solid urinary 12. It may therefore be 
constituents no special action recommended as a good di- 
has been noted, but it in- uretic. 
creases the flow, by raising 
the tension in the glomeruli 
of* the Malpighian bodies. 

Belladonna is also used under one of two conditions which 
cannot accurately be grouped under any specific heading. 

Thus it has been vaunted in whooping-cough, but after 
careful and repeated trials with large and small doses, I am 
compelled to agree with Dr. Kelly that its action in this dis- 
ease is too uncertain to be of much use. But in certain forms 
of spasmodic cough, simulating pertussis, or when the cough 
is merely an occasional, loud, clanging bark, I have derived 
much benefit from belladonna. In epilepsy and chorea it 
has been tried, but without marked success. [As a prophy- 
lactic against scarlet fever, belladonna has attained consider- 
able reputation, perhaps undeservedly. It is to be given in 
small doses, continued twice or thrice daily until danger is 
over.] 

The subcutaneous injection of atropine is said by Dr. Anstie 
to be of great service in lumbago, sciatica, and chronic rheu- 
matism, and to be the best of all remedies for pain in the 
pelvic viscera. It has also been recently observed that the 
addition of a little atropine to the ordinary morphine injection 
tends to obviate the distressing faintness, pallor, and nausea 
which occasionally mar the efficacy of the subcutaneous mode 
of administering this valuable drug. Ringer recommends 
its use in irritative dyspepsia, giving from ^ to i gr. of the 
extract night and morning, and gradually increasing the 
dose. [A solution of atropine (one per cent.), if applied to an 
exposed nerve-pulp, is said to relieve toothache immediately.] 

Drawbacks to the Use of Belladonna. 

Poisonous Symptoms and Antidotes Occasionally the 

use of atropine drops to the eye causes an erysipelatous in- 
flammation about the lids and face, and patients often com- 
plain of the disfigurement and inconvenience arising from a 
widely dilated pupil. Liebreich (St. Thos. Hosp. Rep., 
vol. vii.) points out that the poisonous symptoms of atropine 



202 BELLADONNA. 

are occasionally developed by its introduction into the eye, 
and that they are due, not so much to absorption by the con- 
junctiva as to the fluid trickling through the lachrymal ducts 
into the nose, throat and stomach. This may be avoided by 
telling the patient to rinse his throat occasionally. He also 
notes conjunctivitis, erythema, eczema, and peculiar pearly 
granulations on the conjunctivae, from the long-continued use 
of these drops. Minor degrees of belladonna-poisoning, how- 
ever, need give us no uneasiness. Idiosyncrasy may also 
here be the source of inconvenience, and we may find persons 
affected with dryness of the mouth and throat after very 
small doses. This is always the first indication of the phy- 
siological action of belladonna, and is followed by a peculiar 
sensation of thirst and feverishness, without heightened tem- 
perature, rapid pulse and breathing, a red tongue ; the face 
then flushes, delirium sets in, with great weakness, very hur- 
ried breathing, convulsions, and finally coma, which ends the 
scene. The antidotes are opium, which, within certain 
limits, is antagonistic to belladonna, animal charcoal, the 
fixed alkalies, which destroy its poisonous properties, and 
Calabar bean, which has been shown to be the physiological 
antidote. A direct physiological antagonism has also been 
shown to exist between atropine, muscarine, and jaborandi, 
or pilocarpine, which stimulate the intracardiac inhibitory 
apparatus, and slow the heart. 

One curious point about belladonna is that, although so 
poisonous to man, its destructive influence is very various on 
other animals. The carnivoraare much more readily affected 
by it than the herbivora, many of whom browse on it with 
impunity. Thus a horse has been known to eat eight pounds 
of the leaves without injury; blackbirds feed freely on the 
berries ; and fifteen grains of atropine are required to poison 
a rabbit. 

Dose and Mode of Administration. 

Atropine may be given in phthisical sweating, in pill, in 
doses varying from ¥ -Jq grain (Bartholow) to gr. ^ s to J% 
[Da Costa] ; but it is not very often used internally. In 
heart disease * n gr. of digitaline may be combined with ^\ 
gr. of atropine, and given by hypodermic injection. Discs of 
atropine (lamellae atropinae) have recently been admitted 
to the Br. P. They are composed of gelatine and glycerine, 
and each contains -g oV o S r - °f sulphate of atropine. 



BENZIN — BENZOIN. . 203 

It is well to note that children take not only without in- 
jury, but with benefit, much larger doses than adults, and, 
whilst I have seen a woman display well-marked physiolo- 
gical symptoms after a few 10-minim doses, I have often 
prescribed 20 minims of the [English] tincture for a child of 
two years without anything of the kind. 

. [Asthma Cigarettes. 

$.. Belladonna fol. gr. xcvj ; or (approximately) 6 50 Gm. 

Hyoscyanii fol., 

Stramonii fol., aa gr. xlviij ; or 

Ext. opii gr. iv ; " 

Tabaci fol. gr. lxxx ; " 5 

Aquas bullientis Oj ; " 500 

Macera per boram in vase leviter clauso, cola, et adde — 

Potassii nitrat. £ij 9ij ; or 10160 Gm. 

Potassii arsenitis gv £)j ; " 21|30 " 

M. S. Saturate sheets of bibulous paper in this solution, 
dry and roll them, and use for fumigation as directed. 

Phila. Hosp.~] 



[BENZINUM—BENZIN. 

Petroleum benzine or petroleum ether is a purified dis- 
tillate from American petroleum, consisting of hydrocarbons, 
chiefly of the marsh-gas series, and having a sp. grav. from 
0.G70 to 0.675, and boiling at 50° to 60° C. (122° to 140° 
F.). It should be kept in well-stopped bottles or cans in a 
cool place, remote from lights or fire. Used externally for 
rheumatic or neuralgic pains and for prurigo. Internally as a 
vermifuge, n^xxx (2. Gm.).] 



BENZOINUM— BEN ZOIN. 

[A balsamic resin obtained from Styrax Benzoin, Dryander (N. O. Sty- 
raceas). 

Officinal Preparations, U. S. 

Adeps Benzoinatus (2 per cent. ; Benzoinated lard). 
External use. 

Aeidum Benzoieum. (Enters into Tinctura Opii 
Camphorata.) Dose, gr. x-xxx (.65 to 2. Gm.). 



204 



BENZOIN. 



Ammonii Benzoas. Dose, gr. x-xxx (.66 to 2. Gm.). 
Lithii " " " " 

Sodii " " " " 

Tinetura Benzoini (20 per cent.). Dose, f3ss-f3j 

(2. to 4. Gm.). 

Tinetura Benzoini Composita (Benzoin 12, aloes 

2, storax 8, tolu 4, alcohol q. s. ad 100). Dose, f5j-ij 

(4. to 8. Gm.).] 

Local Action. 



Physiological. 

Tincture of benzoin is a 
stimulant to raw surfaces. 
[Benzoin has the property 
of preventing rancidity in 
ointments, etc., in hot 
weather.] 

Internal Action 

Benzoin has the stimulat- 
ing influence on mucous 
membranes possessed by most 



Therapeutical. 

It is therefore occasionally 
used as an application to foul 
or indolent sores. [The com- 
pound tincture is a useful ap- 
plication to cracked nipples.^ 



of the sum-balsams. Dm 



its passage through the blood 
it becomes converted into 
hippuric acid, and increases 
in some measure the acidity 
of the urine. 

The benzoate of sodium is a powerful hepatic stimulant. 



Benzoin may be prescribed 
with effect in advanced cases 
of bronchitis, and in some 
conditions of chronic irrita- 
tion about the bladder. 

It may be conveniently 
given in the form of the ben- 
zoate of ammonia. 



R. 



S. 



Tincturae benzoini conipositae f £vj ; or 24 

Mncilaginis acaciae f %\ ; " 32 

Sjrupi zingiberis f §ss ; " 16 

Aquae ruenthse piperitae f |vj ; " 192 
Capiat unciain unam quarta qnaque hora. 



Gm 



M, 



For advanced bronchitis. 

[Benzoic acid, in combination with lime, has been used 
successfully in the albuminuria of pregnancy and in Bright's 
disease, by Dr. A. H. Smith, in doses of sixty to eighty 
grains a day.] 1 



I 1 Proceedings Phila. Go. Med. Soc, vol. iii. p. 106.] 



OIL OF BERGAMOT — BISMUTH 



205 



[OLEUM BERGAMII— OIL OF BERGAMOT. 

A volatile oil extracted by mechanical means from the rind of the fresh 
fruit of Citrus Bergamia, var. vulgaris, Risso et Poiteau (N. 0. 
Aurantiaceoz) (De Candolle). 

Used almost exclusively as a perfume, and is an ingredient 
of Spiritus Odoratus. Used for flavoring pomades, etc.] 



BISMUTHUM— BISMUTH. 
[Officinal Preparations, U. S. 

Bismuthi Citras. Dose, gr. j-iij (.06 to 20. Gm.). 

Bismuthi Subearbonas. Dose, gr. xv-xlv (1. to 3. 
Gm.). 

Bismuthi Subnitras. Dose, gr. v-xxx (.32 to 2. 
Gm.). 

Bismuthi et Ammonii Citras. Dose, gr. ij-iv (.13 
to .26 Gm.).] 

Local Action. 

Physiological. Therapeutical. 

Bismuth has no action on It is a good application to 
the unbroken cuticle, but intertrigo, ulceration about 
applied to a raw or mucous the mouth, and as an injection 
surface, it is sedative and in gonorrhoea and leucor- 

rhcea. It has lately been re- 
commendedas a snuff to check 
cold in the head, and the li- 
quor has been praised as an 
application to prolapsus ani 
(Cleland). 



Internal Actions and Uses. 

Bismuth is one of our most 
valued remedies in many 
forms of dyspepsia, the main 



On Digestive Tract Bis- 
muth is sedative to the sto- 
mach, and exerts an astrin- 
gent influence over the intes- 
tines, probably in virtue of 
its local effects. [In large 
doses, the subnitrate of bis- 
muth has caused fatal gastro- 
18 



indications for its use being 
pain and vomiting. When a 
patient suffers acute pain after 
eating, with or without sick- 
ness, the tongue being clean 



206 



BISMUTH. 



and much flatulence present, 
we may give bismutli with 
much confidence ; it is also 
of much service in the vomit- 
ing of drunkards, in pyrosis, 
and in many forms of diar- 
rhoea, more especially that 
met with in children. 



enteritis. When hypoder- 
mically injected bismuth pro- 
duces poisonous effects like 
those from gold or mercury. 
Soluble salts of bismuth, 
therefore, should never be 
given in as large doses as 
the others, very little of 
which enter the circulation. 
Bismuth usually contains a 
small proportion of arsenic] 

Mode of Elimination. 

Very little bismuth is absorbed, and it is principally 
thrown out of the system by the intestines, to whose secre- 
tion it imparts a blackish hue, from the formation of a 
sulphide. 

Mode of Administration, etc. 

The subnitrate of bismuth, which is the most effective 
preparation, may be given simply in powder, either by itself 
or in combination with charcoal or soda; or it may be given 
in solution with hydrocyanic acid, or infusion of gentian ; 
moderately large doses being preferable. 



R 



82 



Gm. 



192 



G r o 



M. 



Bismutlii subnitratis 5U 1 

Mucilaginis acacise f§j ; 

Acidi hydrocyanici diluti ti\x-xx ; 
Infusi gentians q. s. ad f §vj ; ' 

S. Sum at f^ss ter die. 

Liquoris bismuthi et ammouise citrat. [Br.] f giv ; or 16 Gm. 

Sjrupi aurantii, 

Infusi calumbse, aa 

Misce. Sumat unciam unam ter in die. 



f§v 



160 



Bismutlii oxidi 
Acidi oleici 
Cerae albae 
Petrolati 
01. rosse 



Gm. 



5j ; or 
SJ; 

3ix; 

gtt.j; " 

A soothing ointment much recommended by Dr. McCall 
Anderson in eczema. 



06 



M. 



B» Morphinse hydrochloratis er. ii ; or 3 Gm. 

Pulveris acacise 

Bismuthi subnitratis 
Ft. pulv. 

Ferrier's snuff, for cold in the head, influenza, and hay fever. 



3ij; 
3^j; 



M. 



BRAYERA. 207 

The carbonate and oxide of bismuth are seldom used, but 
an agreeable preparation, less effectual, however, than the 
subnitrate, is known as the liquor bismuthi et amrnoniae 
citratis (which contains gr. iij of the oxide to the drachm), 
and lozenges (containing each gr. ij of the subnitrate) are 
also included in the British Pharmacopoeia. 



BRAYERA—BRAYERA (KOUSSO). 

[ The female inflorescence of Brayera anthelmintica, Kunth (N. 0. 
Rosacece, Rosece).] 

Officinal Preparations. 

Extr actum Brayerae Fluidum. Dose, f3ij-iv (8 
to 16 Gm.). 

Infusum Brayerae (6 per cent.). Dose, f^iv-viii 
(125 to 250 Gm.).] 

Effects. 

Physiological. Therapeutical 

The action of kousso is It is therefore occasionally 

poisonous to the tape-worm, used as an anthelmintic, and 

without exerting any irritat- with moderately good effect 

ing or purgative effect. ["Of when given on an empty 

all the remedies for tape- stomach, according to the 

worm none is more efficient rules generally laid dow r n. 
or certain." (Stills'.)] 

Mode of Administration, etc. 

It is well not to use the officinal tincture [Br.], but to get 
the fresh flowers, boiling about half an ounce in three or four 
ounces of water, adding a little lemon-peel, and directing 
the patient to swallow the whole draught, dregs and all. A 
little vomiting sometimes follows, but is seldom troublesome. 
[It is advised to use caution in administering Brayera during 
pregnancy, for fear of abortion. It contains about 3 per 
cent, of a white, or yellowish, crystalline, bitter, resin-like 
substance called Kosin, which is considered the active prin- 
ciple of the drug; 2 to 4 doses of grs. x-(.65 Gm.) being an 
efficient taenicide. It also contains a green resin, a volatile 
oil, tannic acid, etc.] 



208 BROMINE. 

BROMUM— BROMINE. 

[J. liquid non-metallic element, obtained from sea-water, having an irri- 
tant, suffocating odor. 

Dose,gtt. ij-iij (.13 to .20 Gm.), largely diluted: with water. 

Officinal Preparations, U. S. 

Ammonii Bromidum. Dose, gr. xx-xxx (1.30 to 
2. Gm.). 

Calcii Bromidum. Dose, gr. xv-xxx (l.to 2. Gm.). 

Potassii Bromidum. Dose, gr. x-3.j (.65 to 4. Gm.). 

Lithii Bromidum. Dose, gr. v-xx (.32 to 1.30 Gm.). 

Sodii Bromidum. Dose, gr. x-3j (.65 to 4. Gm.). 

Zinci Bromidum. Dose, gr. j (.065 Gm.). 

Syrupus Ferri Bromidi (10 per cent.). 

Aeidum Hydrobromieum Dilutum (10 percent, 
absolute hydrobromic acid). Dose, 5J-U (4. to 8. Gm.). 
(See page 114.) 

Camphora Monobromata. (See Camphor.) 

Antidote. 

Ammonia, followed by the customary treatment for irri- 
tant poisons. 

[Bromine, used as a lotion in olive oil (tr^x to 3j), is 
said to be a specific for the eruption of poison-ivy, rhus 
toxicodendron. 

Bromine is a valuable caustic, and is sometimes used in 
gynecology as an application to the uterus. It is said that 
its mixture with glycerine and alcohol is liable to explode. 
It is useful in hospital gangrene both pure as a caustic, and in 
dilute solution as an antiseptic wash. Used internally, it 
resembles iodine in its effects as an alterant.] 

Bromine being never used to any extent in medicine, we 
shall consider its properties under Bromide of Potassium. 

[At the Ninth International Congress, held at Washing- 
ton in 1887, Dr. De Witt C. Wade, of Holly, Michigan, 
presented the following formula for making extempora- 
neously the officinal Dilute Hydrobromic Acid : Bromide of 
Potassium, ^iv ; tartaric acid, %v ; water, f^vii. Dissolve 
the salt in the water and add the acid. When thoroughly 
mixed set aside to precipitate potassium bitartrate. Decant 
the supernatant fluid and dilute with water fjxvi. The re- 
sult is a ten per cent, solution by weight of hydrobromic acid. 1 ] 

I 1 Transactions of the Ninth International Medical Congress. 
Vol. III., p. 75.] 



BRYONIA — BUCHU. 



200 



[BRYONIA— BRYONIA. 

The root of Bryonia Alba, and of Bryonia Dioica, Linne* (N. 0. 
Cucurbitaceoz) . 

Officinal Preparation. 

Tinctura Bryoniae (10 per cent.). Dose ni,v-f3ij 
(.30 to 8 Gra.). 

Bryonia is an irritant diuretic and drastic purgative, and 
causes congestive headache, sometimes vomiting or gastritis. 
It has been used for the second stage of serous inflammations 
and in rheumatism after fever has subsided. It can be given 
with good results in ordinary colds, with pain and stiffness. 
Its purgative qualities have suggested its use in dropsies ] 



BUCHU— BUCHU. 

[ The leaves of Barosma Betulina, B. Cremdata, and B. Serratifolia 
(N.O. Rutacea3, Diosmeai). 

Officinal Preparation, U. S. 

Extractum Buehu Fluidum. Dose, f5ss-j (2. to 

4. Gm.).] 

Physiological. 

The physiological action 
of Buchu is principally if not 
entirely expended on the 
mucous membrane of the 
genito-urinary organs. It is 
probable that the volatile oil 
which it contains, being rap- 
idly taken into the blood and 
as rapidly excreted by the 
kidneys, acts locally through 
the urine on the lining mem- 
brane of the bladder and 
urethra. [It is also, to some 
extent, diaphoretic] 

The urine is impregnated 
with the peculiar.odor of the 



drug, and is perhaps slightly 
increased in quantity. 



Therapeutical. 

Buchu has long been valued 
by surgeons as a useful remedy 
in chronic catarrh of the 
bladder and the various mu- 
cous discharges from the 
genito-urinary organs depend- 
ing on a relaxed condition of 
the affected parts. [It is 
largely employed in the treat- 
ment of subacute or chronic 
gonorrhoea, resembling oil of 
turpentine in its effects, al- 
though less stimulating. In 
incontinence or retention of 
urine, depending upon want 
of tone in the bladder, it is 
a most useful agent.] 



18 s 



210 CAFFEINE CALAMU! 



CAFFEINA— CAFFEINE. 

[A proximate principle of feebly alkaloidal power, generally prepared 
from the dried leaves of Camellia thea, Link (2V. 0. Ter n sir ami aceai) , 
or from the dried leaves of Caffea Arabica, Linne" (2V. 0. Rubiacece), 
or from Guarana, and occurring also in other plants. ] 

Tea, coffee, guarana, and coca, substances containing the 
same alkaloid, caffeine, have much the same effect. 

Caffeine is a very active substance, causing at first increase, 
but later diminution, of the reflex functions of the cord, with 
nervous convulsions and muscular rigidity, the motor nerves 
not being affected. The heart's action is at first accelerated, 
but afterwards retarded. The excretion of urea is lessened. 

The frequent and prolonged use of tea and coffee causes, in 
some persons, a variety of nervous sensations, sleeplessness, 
numbness and tingling of the extremities, with irritability 
of the heart ; and there is no doubt that much loss of appe- 
tite and flatulent dyspepsia originate in the habit of drinking 
tea shortly before or after meals. The invigorating and re- 
storative effects of tea or coffee are well known, and valued 
by persons undergoing much bodily fatigue. The therapeutic 
indications for tea and coffee are almost restricted to the 
administration of the latter substance in cases of opium- 
poisoning. Citrate of caffeine in two-grain doses has been 
highly recommended in nervous and sick headache. It is 
also in doses of three grains and upwards an efficient diuretic, 
acting by directly stimulating the renal cells without raising 
the blood pressure. It increases at first, but afterwards 
diminishes the excretion of urea. Dr. Thorowgood praises it 
highly in asthma — best given in warm coffee. 

Guarana in twenty-grain doses has been found a useful 
remedy for migraine or sick headache. 



[CALAMUS— CALAMUS (SWEET FLAG). 

The rhizome of Acorus Calamus, Linne" (2V. 0. Aracece). 

Officinal Preparation. 
Ext. Calami Fluidum. Dose,nL x-xv (.65 to 1 Gra.). 
In small quantities calamus is tonic and carminative.] 



OIL OF CAJUPUT — CALCIUM. 211 



[OLEUM CAJUPUTI— OIL OF CAJUPUT. 

A volatile oil distilled from the leaves of Melaleuca Cajuputi, Roxburgh 
(N. 0. Myrtacece). 

Cajuput oil is highly prized in the East Indies as a stimu- 
lant carminative. The ordinary dose is gtt. ij-v (.12 to .32 
Gm.), but it has been given with great success in the col- 
lapse of* cholera, in doses of gtt. xv to f 5j (1. to 4. Gm.). 
It is also used as a rubefacient and counter-irritant, diluted 
with olive oil. Like other oils of this class, it relieves tooth- 
ache when introduced into a carious tooth.] 



CALCIUM— CALCIUM. 

[Caleii Chloridum — (Chloride of calcium prepared 
by fusion.) Dose, gr. v-xx (.30 to 1.30 Gm.). 

Caleii Hypophosphis — Hypophosphite of lime. Dose, 
gr. x-xxx (.65 to 2. Gm.). 

Calx — (Lime recently prepared by calcination.) Quick- 
lime. 

Calx Chlorata — A compound resulting from the 
action of chlorine upon hydrate of calcium, and containing at 
least 25 per cent, of available chlorine. (Used as disinfect- 
ing agent in powder or solution.) 

Calx Sulphurata — A mixture (commonly misnamed 
Sulphide of Calcium) consisting chiefly of sulphide of Cal- 
cium and sulphate of Calcium, in varying proportions, but 
containing not less than 36 per cent, of absolute chloride of 
Calcium, U. S. Dose, gr. \ to ij. (.015 to .13 Gm.). 

Officinal Preparations, U. S. 

Caleii Bromidum. Dose, gr. xv-xxx (1. to 2. Gm.). 

Caleii Carbonas Pr®eipitatus. Dose, gr. x-xl 
(0.65 to 2.60 Gm.). 

Caleii Phosphas Praeipitatus. Dose, gr. x-xxx 
(.65 to 2. Gm.). (Syrupus Calcis Lactophosphatis.) 

Creta Prffiparata. Dose, gr. x-xv (.65 to 1. Gm.). 

Syrupus Hypophosphitum (Lime Hypophosphite 
gr. iij, Potassium hypophosph. and Sodium hypophosph. aa 
gr. j in f 5j). Dose, 3ss-ij (2.-8. Gm.). 



212 CALCIUM. 

Syrupus Hypophosphitum cum Ferro (Ferri 
Lactas 1, Syr. Hypophosphitum 99 parts). Dose, 3 ss ~j (2 
to 4 Gra.). 

Syrupus Caleii Lactophosphatis (grs. x in each 
3j). Dose, gr. i-iv (4-16 Gm.). 

Syrupus Caleis (5 per cent. Calcium Hydrate). Dose, 
T^xx-lx (1.30-4 Gm.). 

Hydrargyrum cum Creta (Mercury 38 pts., Sugar 
of Milk 12 pts., Chalk 50 pts.). Dose, gr. v-xxx (.32 to 2. 
Gm.). 

Troehisci Cretan. (Each 4 grains Prepared Chalk.) 

Pulvis Cretan Compositus (Prepared Chalk 30, 
Acac'a 2, Sugar 50 parts). 

Mistura Cretan (Compound Chalk Powder 20 parts, 
with Cinnamon Water 40 and Water 40 parts). Dose, f'oss 
(16 Gin.). 

Liquor Caleis (0.15 per cent, of Calcium Hydrate). 
Dose, f 3J— iv (4. to 16. Gm.). Lime-water. 

Linimentum Caleis (equal parts of Lime-water and 
Cotton-seed oil). 

Potassa cum Calee (equal parts of Potassa and Lime, 
Vienna paste). Used as a caustic. Vienna paste. 

Also used in the preparation of iEther Fortior, Ammonii 
Valerianas, Aqua Ammonias, Liquor Potassa?, Liquor Sodas, 
Liquor Sodas Chloratas, Quininas Sulphas, Santoninum, 
Spiritus Ammonias, Strychnina and Sulphur Prascipitatum.] 

Local Action. 
Physiological. Therapeutical. 

Some of the preparations Lime is used as a soothing 
of lime, used externally, are application to burns, as in 
sedative or soothing ; others the linimentum caleis ; and 
are astringent. lime-water makes a good 

injection for leucorrhcea, or 
enema for the destruction of 
thread-worms. 

[In croup and diphtheria, 
great relief is afforded by 
breathing the vapor of slaking 
lime, or simply atomized lime- 
water.] 



CALCIUM. 213 



Internal Uses. 

Lime, taken internally, It is therefore used with 

neutralizes acid secretions, benefit in some forms of dys- 
and has astringent proper- pepsia and in diarrhoea, 
ties. liquor calcis being the most 

generally employed prepara- 
tion. Lime-water is also of 
great service in preventing 
the curdling which often 
causes milk to disagree with 
patients of weak digestion. 

Chalk is more astringent than lime, and is an excellent 
remedy, either alone or in combination with opium, for 
diarrhoea. 

Chloride of calcium has been highly praised as a remedy 
for various forms of scrofula. [The dose of fused chloride 
of lime (not calx chlorata) is gr. x-xx (.65 to 1.30 Gm.), 
but it is rarely prescribed.] 

Phosphate of lime has been highly praised by Ringer in 
doses of gr. j to ij (.06 to .12 Gm.) in rickets, where it acts 
by improving the general nutrition of the system, and sup- 
plying structural elements in which the growing bones of 
badly nourished children are often deficient ; the best time for 
administration being after the acute stage has passed away, 
as indicated by the cessation of tenderness. It is also of ser- 
vice in anaemia, general debility, and some forms of diar- 
rhoea, etc. More than gr. j to ij is useless, as it will not 
be absorbed. 

The sulphide of lime is useful in acne, hordeolum, and 
the furuncular diathesis, when boils appear in crops. 

It is also a good remedy in strumous ophthalmia and the 
scrofulous sores of children. Dose gr. A, in a few grains of 
sugar of milk, or better in perles, which prevent decompo- 
sition and conceal the disagreeable odor of the drug. 

Thorowgood much values the hypophosphite of lime in 
phthisis. 

[Freshly calcined lime has some value as a disinfectant, 
as it destroys organic matter by oxidation. For cesspools, 
or sewers, it is less useful than copper sulphate and other 
disinfectants, unless it is used freely and in large quantities. 
Lime-wash applied to walls will aid in disinfecting a room.] 



214 CALENDULA — CALUxMBA. 



[CALENDULA— CALENDULA (MARIGOLD). 

The fresh flowering herb of Calendula Officinalis, Linne 
(N. 0. Compositce). 

Officinal Preparation. 

Tinetura Calendulae (20 per cent.). Dose, 5 ss -lj 
(2. to 8. Gm.).] 

Marigold contains some volatile oil, an amorphous bitter 
principle, yellow coloring matter, etc. It is reputed to pos- 
sess tonic, alterative, antispasmodic, diaphoretic, and emme- 
nagogue properties. As the Pharmacopoeia directs that only 
the fresh plant is to be used, it can only be prescribed in the 
form of the tincture, which has also been used for the same 
purposes as tincture of arnica, and is a satisfactory substitute 
for it in sprains, bruises, etc.] 



CALUMBA— CALUMBA (COLUMBO). 

[ The root of Jateorrhiza Calumba (Miers), (2V. 0. Menispermaceaz). 

Officinal Preparations, U. S. 

Extraetum Calumba? Fluidum. Dose, nrxv- 
xxx (1. to 2. Gm.). 

Tinetura Calumbae (10 per cent.). Dose, f3J-ij (4. 
to 8. Gm.).] 

Local Action. 

Calumba has no local action. 



Constitutional Action. 

Physiological. Therapeutical. 

On the Digestive Fane- Calumba is a good tonic 

tions Like all bitter tonics, in deficient appetite from in- 

calumba stimulates the appe- digestion or simple want of 

tite, and increases slightly tone, in various dyspeptic 

the secretion of saliva and conditions, and in most en- 

the gastric juice. It is lighter feebled states of the consti- 

and more agreeable than tution, from whatever cause 

some others of the class, and they may arise. [As it does 

has been believed to have not contain tannic acid, it 

sedative properties, in virtue may be given in combination 

of which it may be bene- with iron. J 



LIME — GAMBOGE. 215 

ficially given in sickness and 
vomiting ; but of this we 
have been unable to obtain 
reliable evidence. 

Mode of Administration. 

Calumba is usually given in combination either with iron, 
with alkalies, or with other tonics. Thus: — 

]$. Ferri et potassii tartratis 3^ ss I or 6jGm. 

Potassii bicarbonatis 5U '■> " 8| " 

Syrupi hemidesnii [Br.] f§j ; " 321 " 

Infusi calumbse ifvij ; " 224| " 

Misce, fiat mistura. Capiat unciain unam bis in die. 



I£. Pulveris calumbse gr. x ; or 

Sodii bicarb. gr. xx ; " ] 

Pnlv. rhei gr. v ; " 

Pulv. zingiberis gr. x ; " 

M. Fiat pulvis bis in die sumendus ante cibum. 

A useful powder in some forms of dyspepsia. 



65 Gm. 
30 " 
32 " 
65 " 



CALX— LIME. 
(See Calcium.) 



CAMBOGIA— GAMBOGE. 

[A gum resin obtained from Garcinia Hanbarii, Hooker filius (N. 0. 
Guttiferoz) . 

Dose, in substance, gr. ij-iij (.12 to .20 Gm.). 

It enters into Pilulae Catharticae Composita?.] 

Local Action. 

Gamboge has no local action, and differs from some other 
remedies of the same class in not exerting its purgative 
effects when applied to a raw surface or injected into the 
cellular tissue. 

Constitutional Action. 

Physiological. Therapeutical. 

On the Digestive and Se- Gamboge is a drastic, hy- 

creting Organs Gamboge dragogue cathartic, formerly 

exerts a good deal of irri- much used where free purga- 



216 GAMBOGE. 

tating effect, acting more tion of watery fluid seemed 
especially on the small intes- to be indicated, as in cardiac 
tines, and producing the dis- dropsy ; but it is not only 
charge of large quantities of disagreeable and irritating, 
watery fluid. If given in but uncertain, and has there- 
sufficient quantity, inflam- fore been in great measure 
mation and ulceration of the superseded by other remedies 
stomach and intestines may on which more dependence 
supervene, and death has can be placed. It has been 
followed the administration shown by Rutherford to stim- 
of a single drachm of the ulate the intestinal glands, 
powder. It is also usually but not the liver, 
looked upon as a diuretic, 
but no trustworthy evidence 
has been given of its efficacy 
in this direction. 

Absorption, Mode of Elimination, etc. 

In order to insure its full absorption it seems necessary 
that gamboge must be previously dissolved in the bile, as we 
have seen that local application does not produce any purga- 
tive effect. It is, of course, thrown out in great measure by 
the intestines, but the coloring matter is excreted by the 
urine, to which it imparts a bright yellow tinge. 

Mode of Administration, Dose, etc. 

The great objection to the use of gamboge is its uncer- 
tainty, as we can never precisely foresee the cases in which 
it will cause troublesome vomiting and purging. To try and 
obviate this, therefore, as well as to conceal its acrid taste, 
we generally combine it with other drugs ; but on the whole 
I think I am justified in saying that gamboge has no thera- 
peutic advantage which cannot be obtained more conveniently 
and agreeably by the use of other purgative drugs. 

We may most conveniently prescribe the compound pill 
(P. Br.), which contains gamboge, aloes, cinnamon, hard soap, 
and syrup, and of which the dose is from 5 to 15 grains. 

[The compound cathartic pill (U. S. P.) contains : Ab- 
stract of jalap, gr. j ; calomel, gr. j ; compound extract of 
colocynth, gr. j^, and gamboge, gr. £. It is a good purga- 
tive, but often gripes ; this might be obviated by the admin- 
istration of a carminative at the same time. Dose, one to 
three pills.] 



CAMPHOR. 21T 



CAMPHORA— CAMPHOR. 

f A stearopten derived from Cinnamomtim Camphora, F. Nees and Eber- 
maier (N. 0. Lauraceoz), and purified by sublimation. 

Dose, in substance, gr. i-ij (.06 to .13 Gm.). 
Officinal Preparations, U. S. 

Aqua Camphorae. (About gr. iv to each ounce.) 
Dose, f 3j-t "£ss (4. to 16. Gm.). 

Linimentum Camphorae (camphor 20 pts., cotton- 
seed oil 80 pts.). External use. 

Linimentum Saponis (soap 10, camphor 5, oil of 
rosemary 1, alcohol 70, water q. s. ad 100 pts.). External 
use. 

Spiritus Camphor® (10 per ct.). Dose, ni v-x 
(.32 to .65 Gm.). 

Tinetura Opii Camphorata (Paregoric Elixir : see 
Opium.) Dose, fgss (16. Gm.). 

Ceratum Camphorae (3 perct.). External use. 

Camphora Monobromata. Dose, gr. ij-x (0.13 to 
.65 Gm.). 

It also enters into Linimentum Belladonnas, Linimentum 
Sinapis Compositum, Mistura Chloroformi, and Pulvis Mor- 
phine Compositus.] 

Antidotes. 

Opium and stimulants.] 

Local Effects. 

Physiological. Therapeutical. 

Camphor has some rube- Camphor forms an ingre- 
facient properties, reddening dient of most of the lini- 
and irritating the skin. ments in common use. 

Internal Action. 

1. Brain and Nervous 1. Camphor is not used on 
System — Camphor in large account of its action on the 
doses causes a good deal of, nervous system, and the re- 
giddiness and confusion of suits of the few experiment- 
ideas, even amounting in ers who have been bold 
some cases to delirium. enough to try the effects of 

Muscular weakness is at large doses on themselves 
19 



218 



CAMPHOR. 



first observed, but this rap- 
idly gives way to violent epi- 
leptiform convulsions and 
almost maniacal excitement. 
In frogs, well-marked lower- 
ing of the reflex irritability 
of the spinal cord has been 
observed. 



2. Circulation. — In small 
doses camphor seems to stim- 
ulate the heart's action, but 
after the administration of 
larger quantities great car- 
diac prostration has been ob- 
served by Dr. Geo. Johnson 
and others. 



3. Respiration and Tem- 
perature No influence on 

the respiration is noted, but 
there is a marked lowering 
of temperature. 

4. Digestive and Secreting 

Organs In large doses, 

some irritation of the gastro- 
intestinal mucous membrane 
has been observed, with dia- 
phoresis, and the sexual ap- 
petite seems to be diminished. 



have not been of a very en- 
couraging nature. The bro- 
mide of camphor [camphora 
monobromata] is a good 
remedy in nervous palpitation, 
and in irritation of the urina- 
ry and generative organs, and 
has a decidedly lowering in- 
fluence on the temperature. 
[It is moderately stimulating 
and diaphoretic, and possesses 
anodyne and narcotic influ- 
ence. In the spasmodic and 
nervous complaints of women, 
camphor is occasionally em- 
ployed.] 

2. Camphor has been found 
of service in the early stages 
of coryza, but must be here 
used with caution, as the 
homoeopathic tincture, which 
is generally prescribed, is now 
known to be a very strong 
preparation, and Dr. George 
Johnson and others have de- 
scribed cases in which exces- 
sive weakness and faintness, 
with great cardiac and mus- 
cular prostration, followed 
doses of from 15 to 20 minims. 



4. Camphor is said to be 
a good remedy in summer 
diarrlioza. 



It is a popular antidote in 
chordee. 



AMERICAN HEMP — INDTAN HEMP. 219 



[Hope's Camphor Mixture. 

fy. Acid, nitrosi f3j ; or 4| Grm. 

Tinct. opii deod. nixl ; " 2 60 " 

Aquae camphorae q. s. ad f^viij ; "2561 M. 

Dose, a tablespoonful, after each evacuation. 



For dysentery.] 



[CANNABIS AMERICANA— AMERICAN HEMP. 

nnabis Sativa, Linne (JV. 0. Urt 
SoutJiern United States and 

(No officinal preparations.)] 



Cannabis Sativa, Linne (JV. 0. Urticaceoz, Cannabineoz) , grown in 
Southern United States and collected while flowering. 



CANNABIS INDICA— INDIAN HEMP. 

[ The flowering tops of the female plant of Cannabis Sativa, Linne (JV. O. 
Urticaceoz, Cannabinece) , grown in the East Indies. 

Officinal Preparations, U. S. 

Extractum Cannabis Indie®. Dose, gr. i (.03 
Gm.). 

Extractum Cannabis Indie® Fluidum. Dose, 
ftti-1 (.03 to .06 Gm.). 

Tinctura Cannabis (20 per cent.). Dose, gtt. x- 
xx (.65 to 1.30 Gm.).] 

Local Action. 
Indian hemp is never used locally. 

Internal Actions. 

Physiological. Therapeutical. 

1. On Brain and Nervous 1. Indian hemp may be 

System Indian hemp, like used as a narcotic when other 

opium, possesses a double remedies fail ; but its action 
exciting and sedative action, is so uncertain and irregular, 
the brain being stimulated and the difficulty of procur- 
ing pleasant exhilaration be- ing reliable preparations so 
fore sleep sets in. This pre- great, that our present know- 
liminary effect, however, is ledge does not enable us to 
more powerful and lasting lay down any practical rules 
than in the case of opium, for its employment. Dr. 



220 



AMERICAN HEMP — INDIAN HEMP. 



and the subsequent condition 
of slumber is usually dis- 
turbed by dreams and spec- 
tral illusions. Various au- 
thors have given graphic de- 
scriptions of the intellectual 
disturbance produced by this 
drug, dwelling more especi- 
ally on a peculiar feeling of 
double consciousness, leading 
on, in some cases, to partial 
catalepsy. 

We also find indications 
of some special affection of 
the sensory nerves, a marked 
degree of numbness and ting- 
ling, ushering in cutaneous 
anaesthesia and diminution of 
the muscular sense. 

2. Circulation — Some in- 
creased rapidity of pulse has 
been observed during the ac- 
tion of Indian hemp ; but it 
is probable that this is only 
due to the condition of nerv- 
ous excitementwhich we have 
just described. 

3. Digestive System. — No 
special effect seems to be pro- 
duced on the stomach or in- 
testinal canal, and the absence 
of constipation following its 
use gives Indian hemp one 
advantage over opium. 



Clouston, however, has ob- 
tained valuable assistance in 
acute mania by prescribing 
the tincture in combination 
with bromide of potassium. 
Although later experience has 
not confirmed the pretensions 
of those who formerly vaunted 
Indian hemp as a cure for 
hydrophobia, chorea, tetanus, 
and allied nervous ailments, 
we may sometimes produce 
good results in neuralgia and 
migraine by its cautious use. 



Dose and Mode of Administration. 

# Tincturse cannabis Indicse f^j ; or 4 Gm. 

Mucilaginis acacia? f§j ; " 32 ' 

Syrupi zingiberis f§ss ; " 16 ' 

Aqua? menthse piperita? f^ v J '■> il 192 " 

Misce, fiat mistura. Capiat vmciam unam quarta quaque 
hora. 

In neuralgia, etc. 



CANTHARIDES. 221 

CANTHARIS—CANTHARIDES (SPANISH FLIES.) 

[Cantkaris vesicatoria, De Geer {Class Insecta; Order Coleoptera). 

Officinal Preparations, U. S. 

Tinetura Cantharidis (5 per cent.). Dose, r^iij-v 
(.20 to .32 Gm.). 

Ceratum Cantharidis. (For spreading blisters.) 

Ceratum Extraeti Cantharidis. (External use.) 

Charta Cantharidis. (Blistering paper. External 
use.) 

Collodium cum Cantharide (60 per cent.). 

Linimentum Cantharidis (Cantharis 15, 01. tere- 
binth q. s. ad 100 parts). 

Emplastrum Picis cum Cantharide. 

Poisoning. 

Cantharides is an acrid and corroding animal poison. Its 
prominent symptoms are a burning sensation in the throat ; 
violent pain in the stomach and bowels ; nausea, vomiting, 
and purging — the ejections being frequently bloody and 
purulent ; great heat and irritation of the urinary organs, 
sometimes the most painful priapism ; pulse quick and hard ; 
and convulsions, tetanus, delirium, and syncope. 

The morbid appearances are principally inflammation and 
erosion of the stomach. If in substance, fragments of the 
flies, with their characteristic green, shining appearance, 
will be found adhering to the mucous coat, or mixed with 
the contents of the stomach ; there are also marks of inflam- 
mation in the intestines and urinary organs, but these are 
most evident when death does not soon follow the ingestion 
of the poison. 

Treatment — The promotion of vomiting by means of 
warm demulcents; copious dilution, bleeding, the warm 
bath, opiate frictions, enemata of mutton-broth, laudanum, 
etc. Camphor, though not an antidote, alleviates some of 
the most distressing symptoms ; the bromides are also ser- 
viceable. In extreme cases the administration of an anaes- 
thetic may be necessary. 

Antidote. 

There is no antidote for cantharides.] 
19* 



222 



CANTHARIDES. 



External Actions. 



Physiological. 

The first effect of the ap- 
plication of cantharides to the 
skin is tingling and smarting, 
speedily followed by vivid 
redness and severe burning 
pain. To this succeeds the 
formation of large blebs, con- 
taining a watery fluid rich in 
albumen and fibrine ; and if 
the blister be allowed to re- 
main for any lengthened pe- 
riod in contact with the skin, 
ulceration and sloughing may 
supervene. It has been found 
that the moderate counter- 
irritant action of cantharides 
causes the copious exudation 
of white blood-corpuscles into 
the subcutaneous areolar tis- 
sue, with engorgement of the 
more superficial structures 
underlying the skin, whilst 
the deeper strata look pale, 
anaemic, and flabby ; the lungs 
even being affected in this 
way. It has also been shown 
that the irritant action of can- 
tharides may penetrate 
through the skin, and cause 
redness and inflammation of 
the pleura and peritoneum. 
The first constitutional effect 
of a blister is a slight eleva- 
tion and subsequent depres- 
sion of the temperature, with 
weakening of the action of 
the heart. 

It not uncommonly hap- 
pens that cantharides maybe 
absorbed through the skin, 



Therapeutical. 

Blisters are used to fulfil 
the following indications : — 

1. To relieve pain. There 
can be no doubt that blisters 
frequently check pain most 
effectually, as in subacute 
pleurisy, pleurodynia, gas- 
tralgia, sciatica, and neural- 
gia, it being important that 
in this last-named affection 
the counter-irritant should be 
placed as near as possible to 
the root of the affected nerve. 

2. To check inflammatory 
conditions. There is no doubt 
that some local inflammations 
may be checked by blistering 
a neighboring vascular area. 
Thus, in iritis and some other 
inflammatory affections of the 
eye, benefit may be procured 
in this way ; and in acute 
rheumatism blisters applied 
immediately above the in- 
flamed joints rapidly remove 
pain and swelling. 

On this principle, also, Mr. 
F. Jordan recommends his 
iodine treatment of localized 
surgical affections already re- 
ferred to. 

In how far inflammations 
of internal organs may thus 
be treated with advantage is 
a somewhat open question : 
for although the withdrawal 
of blood from the deeper 
structures might theoretically 
be considered beneficial, it is 
practically found that the 



CANTHARIDES. 



223 



and cause kidney irritation, 
indicated by difficult and 
painful micturition and the 
passage of blood. 

[Blisters are spread with 
the cerate and not with the 
ointment of cantharides; the 
prescription being in this 
form : — 

I£. Cerati cantharidis q. s. 

Ft. emplastrum 2x2 in. 
S. Apply as directed. 

A better method of making 
blisters however is mentioned 
at the end of the article on 
the next page.] 



Internal 
Physiological. 

Cantharides is a gastro- 
intestinal irritant, and also a 
renal stimulant and diuretic, 
causing an increased flow of 
urine, but frequently giving 
rise to a good deal of stran- 
gury, with painful, frequent, 
and difficult micturition, and 
bloody urine. This irritation 
may spread by sympathy to 
other allied organs, and uter- 
ine excitement on the one 
side, or excess of venereal 
appetite with chordee and 
seminal emissions on the 
other, may follow the admin- 
istration of large doses. 



pain and annoyance of blis- 
ters add to the feverish dis- 
comfort of the victims of 
acute disorders. 

3. To promote absorption. 
Blisters are supposed to aid 
the absorption of effused pro- 
ducts, fluid or solid, and are 
therefore much used in tho- 
racic dropsy, either pleural 
or pericardial, the latter 
stages of pneumonia, chronic 
joint-disease, etc. 

4. To stimulate and alter 
vascular or nervous functions, 
etc. Blisters may be employed 
to rouse patients from the stu- 
por of typhus, or narcotic 
poisoning, or various brain 
affections, to check obstinate 
vomiting, and under various 
other conditions laid down in 
works on practical medicine. 

Action. 

Therapeutical. 

Cantharides is not much 
used internally, on account of 
its irritating properties. It 
is, however, occasionally pre- 
scribed in pyelitis and some 
chronic affections of the kid- 
ney, and in chronic diseases 
of the spine. 

Some authorities also have 
praised it highly in psoriasis. 
It has also been used for the 
purpose of procuring abortion, 
and it possesses emmenagogue 
properties. 



224 capsicum. 



Cautions. Mode of Administration. 

We must use blisters with caution under the following 
circumstances :— 

In the aged, infirm, or very young, where troublesome 
ulceration is apt to ensue. 

In acute inflammatory conditions, and more especially 
those of the kidney. 

To cicatricial tissue, or to parts deprived of some of their 
vitality by the withdrawal of nervous influence, as in para- 
plegia. 

Blisters are usually kept on from ten to twenty hours, but 
we may well limit the period to six or eight hours, and de- 
velop the blebs by a subsequent poultice. When the desired 
effect has been produced, let out the watery fluid, and apply 
a thick layer of cotton-wool. 

[A good method of making blisters without pain is to ap- 
ply collodium cum cantharide, or blistering collodion, over 
the desired area. If well applied it is efficient, prompt, and 
painless, and does not cause strangury. No poulticing is 
needed, as a rule, the application of a piece of waxed paper 
or oiled silk to protect it from the air only being employed. 
The epidermis over the blister should not be removed.] 



CAPSICUM—CAPSICUM. 

[Syn. Cayenne and African Pepper. 
The fruit of Capsicum fastigiatum, Blume (N. 0. Solanacece). 

In substance. Dose, grs. v-x (.80 to .65 Gra.). 

Officinal Preparations, U. S. 

Extraetum Capsiei Fluidum. Dose, n^ v-x (.30 
to .65 Gm.), 

Oleo-Resina Capsiei. Dose, gtt. ^ to iij (.03 to .20 
Gm.). 

Tinctura Capsiei. Dose, f3-ij (4. to .8 Gm.). 

Emplastrum Capsiei. (4 sq. in. or 10 cm. contains 
gr. 4, or .25 Gm., of the oleo-resin).] 

This is a topical stimulant to the mucous membranes, 
exciting the appetite in small doses, but in larger quantities 
causing gastro-enteritis. In some forms of sore throat, as in 



ANIMAL CHARCOAL — WOOD CHARCOAL. 



225 



the early stage of tonsillitis, or in simple relaxation of the 
mucous membrane, it forms a useful addition to a gargle as 
infusum capsici. 

Recently it has been highly praised by Dr. Lyons, of Dub- 
lin, in ten-minim doses of tincture before meals, for the re- 
lief of the nausea, depression, and drink-craving of the con- 
firmed dipsomaniac. 

]£. Tincturse capsici, 

Tincturse nncis vomicae, aa TT\,x ; " 60 Grm. 

Acidi nitrici diluti ll^xx ; " 1 30 " 

Aquas q. s. ad fjj ; " 32J " M. 

Fiat haustus ter in die sumendus. 

Useful in drink-craving. 



CARBO-ANIMALIS— ANIMAL CHARCOAL. 

[Animal Charcoal prepared from bone.'] 



CARBO LIGNI— WOOD CHARCOAL. 

[ Charcoal prepared from soft wood. 
Officinal Preparation. . 

Carbo Animalis Purificatus. 

(Used in pharmacy.)] 

Local Action. 



Physiological. 

Charcoal has no purely 
local action on any tissue 
with which it is brought in 
contact, and as it is quite in- 
soluble it can exert no gene- 
ral influence on the functions 
of the body. It is therefore 
simply a mechanical agent 
and acts in virtue of the fol- 
lowing properties : — 

1. It not only freely ab- 
sorbs gases within its pores, 
but oxidizes and destroys 



Therapeutical. 

1. In virtue of its absorb- 
ing powers, charcoal is used 
in many of those cases of dys- 
pepsia where large quantities 
of gas are formed by prema- 
ture decomposition of the 
food, and where much pain, 
nausea, and want of appetite 
are experienced by the pa- 
tient. In consumption and 
many chronic stomach dis- 
orders, charcoal acts well by 
relieving- the flatulence which 



226 



WOOD CHARCOAL. 



those of an offensive and in- 
jurious nature, as sulphuretted 
hydrogen ; and further, it 
also deodorizes, by oxidation, 
and destroys organic impuri- 
ties of all kinds, thus decolor- 
izing solutions which contain 
them. It is extremely doubt- 
ful, however, in how far the 
explanation usually given of 
the therapeutic action of 
charcoal is satisfactory. We 
know that moisture destroys 
its absorptive powers, and the 
dose given must be too small 
to exert any real influence 
over gases contained in the 
stomach or intestines. More 
probably it acts mechanically 
by the small insoluble parti- 
cles stimulating the mucous 
membrane and causing its 
vessels to contract. (Brun- 
ton.) 



2. Animal charcoal pos- 
sesses the power of render- 
ing various vegetable poisons 
inert by placing them in a 
form of combination beyond 
the absorptive powers of the 
stomach. 



is often the chief discomfort 
of the sufferer. Charcoal is 
also an excellent deodorizer 
and antiseptic, and is used 
for these purposes in the con- 
struction of filters, contact 
for four months being suffi- 
cient to purify the foulest and 
most deeply stained waters ; 
and if the organic matter 
present does not exceed from 
1 to 2 grains per gallon the 
charcoal will permanently re- 
tain its cleansing properties. 
It may also be of great ser- 
vice in absorbing and destroy- 
ing offensive effluvia in the 
neighborhood of sewers or 
drains, and it used to be a 
fashionable application to 
unhealthy ulcers ; butcleaner 
and equally effective antisep- 
tics have now entirely dis- 
placed it from popular favor. 

It is also occasionally em- 
ployed in the formation of 
respirators and as an adjunct 
to tooth powders. 

2. If we are called very 
early to a case of poisoning by 
opium, aconite, strychnine, 
or other vegetable poison, we 
may hope to do some good 
by charcoal, provided that 
absorption of the poisonous 
agent has not yet taken place 
to any extent. 

Mode of Administration. 

As a medicinal agent vegetable charcoal alone is used, 
and may be given in doses of from a tea- to a table-spoonful, 
great care being taken to insure perfect freshness, as its ab- 
sorptive powers are seriously impaired by keeping. It may 



BISULPHIDE OF CARBON — CARDAMOM. 227 

be combined effectively with bismuth, or given in sandwich 
form between bread and butter, or moistened with spirit in 
a wineglass before suspension by water; but in any case its 
unsightly appearance, gritty consistence, and insolubility 
interfere with its prescription in elegant form, and we may 
advise our patients with advantage to make use of the varie- 
ties of biscuits, lozenges, and capsules, which the ingenuity 
of chemists has devised. 

As an antidote, animal charcoal must be given in con- 
siderable doses, as it is calculated that half an ounce is 
required to neutralize one grain of vegetable alkaloid. As 
an antiseptic it may be placed in shallow pans close to the 
outlet of drain or sewer ventilating shaft [in order to serve 
as a danger signal]. 



[CARBONEI BISULPHIDUM — BISULPHIDE OF 
CARBON (CS 2 -76). 

This compound corresponds in composition with carbon 
dioxide (C0 2 ), sulphur replacing oxygen. It is a clear 
liquid, of very diffusive and offensive odor, and is highly in- 
flammable. As it is a very decided poison, it is not used 
internally. Externally it has been used as a local anaes- 
thetic, and, as it causes redness of the skin, as a counter- 
irritant for relief of neuralgia, etc., but its odor prevents its 
use among patients who are at all fastidious. 

Its vapor may be locally used in ear disorders attended by 
defective secretion of cerumen.] 



CARDAMOMUM— CARDAMOM. 

[The fruit of Elettaria Cardamomum, Moton (IV. 0. Zin giber aceoz). 

Officinal Preparations, U. S. 

Extraetum Aromatieum Fluidum (Pulv. aro- 
mat. 100 gr. ; alcohol, q. s. ad 100 cc). Dose, gr. v-xxx 
(.30 to 2. Gm.). 

Pulvis Aromaticus (Cardamom, Nutmeg, aa 15; 
Cinnamon and Ginger aa 35 parts). Dose, gr. x-xxx (.65 
to 2. Gm.). 



228 CARAWAY — CLOVES. 

Tinetura Cardamomi (15 per cent, dilute alcohol 
q. s.). Dose, f'3i-ij (4. to 8. Gm.). 

Tinetura Cardamomi Composita. Dose, f5j-iv 
(4. to 16. Gm.). (Cardamom 2; Cinnamon 2; Caraway, 
1; Cochineal J; Glycerin 6; Dilute alcohol q. s. ad 100 
parts.) 

This is an agreeable stimulant and flavoring adjunct. It 
also enters into the Compound Tincture of Gentian, Tinetura 
Rhei, Tinetura Rhei Dulcis, Vinum Aloes, and Compound 
Extract of Colocynth.] 



[CARUM— CARAWAY. 

The fruit of Carum Carvi, Linne (N. 0. Umbelliferoz) . 

Officinal Preparation, U. S. 

Oleum Cari. Dose, gtt. j-v (.06 to .30 Gm.). 
Enters into the Tinetura Cardamomi Co., and the Spts. 
Juniperus Co. 

Caraway is an agreeable aromatic, used as a stomachic, or 
to prevent the griping of other medicines. The oil is most 
frequently employed, but an infusion may be made contain- 
ing 3ij to Oj.] 



CARYOPHYLLUS— CLOVES. 

[ The unexpanded flowers of Eugenia Caryophyllata, Thunberg 
(N. 0. Myrtacece). 

Officinal Preparation, U. S. 

Oleum Caryophylli. Dose, gtt. ij-vj (.12 to .40 
Gm.). 

Cloves also enter into Tinetura Lavandulae Composita, 
Tinetura Rhei Aromatica, Syrupus Rhei Aromaticus, and 
Vinum Gpii.] 

Cloves are a stimulating stomachic, and may be given in 
substance in doses of gr. v-x (.30 to .65 Gm.).] Cloves, 
pimento, and oil of cajuput are carminative and perhaps anti- 
spasmodic, and may be useful in flatulent colic, hysteria, 
etc., more especially as adjuncts to other remedies. 



CASCARILLA — CASTANEA. 229 

[Clove-tea is a domestic remedy for dysmenorrhea and 
colic. The oil is frequently used to relieve toothache, a piece 
of cotton tinctured with it being placed in the cavity. Spice 
plasters are sometimes employed to relieve pain, a good 
formula being : ginger, cloves, cinnamon, and black pepper, 
in powder, each an ounce ; tincture of ginger, half an ounce ; 
honey enough to make a stiff paste.] 



CASCARILLA— CASCARILLA. 

[The bark of Croton Eluteria, Bennett (N. 0. Euphorbiacece).'} 

Cascarilla is a light and agreeable tonic, in doses of grs. 
x-xxx (.65 to 2. Gm.). 



[CASSIA FISTULA— PURGING CASSIA. 

The fruit of Cassia Fistula (iV. 0. Leguminoso3, Cozsalpinieoz) . 

Cassia pulp is laxative in doses of one or two drachms, 
but is rarely used except in the officinal combination, Con- 
fectio Sennae, which is a favorite remedy against constipa- 
tion in pregnancy. Dose, 5j-i y (4. to 16. Gm.).] 



[CASTANEA— CASTANEA (CHESTNUT). 

The leaves of Castanea Vesca, Linne" (N. 0. Cupellifero3) , collected in 
September or October, while still green. 

Officinal Preparation. 

Extraetum Castaneae Fluidum. Dose, fgj-ij (4. 
to 8. Gm.). 

The leaves contain tannin and other constituents not yet 
analyzed. The fluid extract has some reputation in the 
treatment of whooping-cough, and might be useful as an 
astringent in bowel affections.] 



20 



230 CATECHU — CAULOPHYLLUM. 



CATECHU— CATECHU. 

[An extract prepared from the wood of Acacia Catechu, Willdenow 
(N. 0. Leguminosai, Mimoseoz). 

Officinal Preparations, U. S. 

Tinctura Catechu Composita. (Catechu 12 per 
ct , cinnamon 8 per ct.) Dose, f3j— "J (4. to 12. Gm.). 

Troehisci Catechu. (One grain each.) Dose, 1 
to 5.] 

Internal Effects. 

Physiological. Therapeutical. 

Catechu has powerful as- It is a much used drug in 
tringent properties. the relaxed conditions of va- 

rious mucous membranes, 
but more especially in diar- 
rhoea, and it constitutes an 
essential ingredient in the 
mixtures generally prescribed 
for the relief of that condi- 
tion. 

fy. Tincturge catechu f5vj ; or 24 Gm. 

Palveris cretae aromatici [Br.] £ij ; " 8 

Tincturse opii ' f5ij ; " 8 

Mucilaginis acacise f^j ; " 32 

Aquae cinnamomi q. s. ad f^vj ; " 192| 

Misce, fiat mistura, cujus sumat sernunciam post singulas dejec 
tiones liquidas. 



[CAULOPHYLLUM— CAULOPHYLLUM (BLUE 
COHOSH). 

The rhizome and rootlets of Caidophyllum thalictroides, Michaux 
(2V. 0. Berberidaceai). 

Caulophyllum contains saponin and two resins ; the so- 
called caulophyllin is a resinous extract prepared from a 
concentrated tincture by dilution with water. Blue cohosh 
is used as an emmenagogue and parturifacient ; it is also 
diuretic, and, owing to the saponin which it contains, it 
should possess value as an expectorant.] 



WAX — OXALATE OP CERIUM. 231 



CERA— WAX. 

[Cera Alba. Yelloiv wax bleached. 
Cera Flava. A peculiar concrete substance prepared 
by Apis mellifica. 

Wax is a good excipient. It enters into Ceratum (white 
wax 30, lard 70), and is the basis of the cerates (see below). 
It also enters into pills, ointments, plasters, and supposito- 
ries. It was an ancient remedy for dysentery. 

Yellow wax is a constituent of Unguentum (lard 80, wax 
20), also of Ceratum Resinee and the compound Cerates.] 



[Cerata. 

List of Cerates officinal in the U. S. Pharmacopoeia : — 

Ceratum Carnpliorse. Ceratum Plumbi Subacetatis. 
" Cantharidis. " Resinse. 

" Cetacei. " Sabiuae. 

" Extracti Cantharidis. 



[CERII OXALAS— OXALATE OF CERIUM 

(Ce 2 (C 2 OJ 3 9H 2 O-708). 

A white granular powder, insoluble in water or alcohol; odorless and 
tasteless. ] 

The oxalate of cerium, in doses of from gr. j to gr. ij, is 
a popular remedy in the vomiting of pregnancy, its mode of 
action being quite unexplained, and its success being, accord- 
ing to my own experience, greatly exaggerated. 

It is generally prescribed in the form of pill. 

R. Cerii oxalatis gr. xxiv ; or 150 Gm. 

Extracti gentianse gr. xxxvj ; " 240 " 

Misce, fiant pilulae duodecim, quarum capiat unam bis in die. 

[Disappointment from the use of this drug sometimes re- 
sults from the presence in the commercial oxalate of cerium 
of salts of lanthanum, didymium, and other impurities. The 
chemically pure oxalate of cerium is said to be one of the 
most efficient remedies against the vomiting of pregnancy 
that we possess ; given in powder, in pill, or suspended in 
mucilage.] Another reason for disappointment probably is 



232 SPERMACETI — CHELIDONIUM. 

that the usually prescribed dose is much too small, borne 
good authorities advise us to give ten grains every four hours, 
one dose being invarably taken before the patient rises from 
bed. It has also recently been recommended in doses of 
from 5 to 10 grains as a very efficient remedy for cough [and 
in smaller doses to children for whooping-cough.] 



CETACEUM— SPERMACETI. 

[ A peculiar concrete fatty substance obtained from Physeter macrocephalus, 
Linnt (Class Mammalia, Order Cetacece).] 

Officinal Preparations, U. S. 

Ceratum Cetaeei (spermaceti 10, white wax 35, olive 
oil 55 parts). 

Unguentum Aqua Rosae. Cold cream (expressed 
oil of almonds 50, rose water 30, spermaceti and white wax 
aa 10 parts). 

Requires no special notice. [Its internal use has been 
generally abandoned. The cerate, a perfectly bland prepa- 
ration, may be used as a dressing to blistered surfaces. The 
unguentum aquas rosse, or cold cream as it is called, is much 
used for chapped hands and lips, and excoriated places.] 



CETRARIA— CETRARIA (ICELAND MOSS). 

[Cetraria Islandica, Acharius (N. O. Lichenes). 

Officinal Preparation, U. S. 

Decoetum Cetrari® (5 per cent.). Dose, f^ss-iv 
(16. to 128 Gm.).] 

This plant is supposed to have nutritious properties [and 
formerly enjoyed a great reputation as a demulcent and 
tonic in pulmonary affections^' 



[CHELIDONIUM— CHELIDONIUM (CELANDINE). 

Chelidonium majus (N. 0. Papaveracece) . 

Dose, gr x-xl (.65-260 Gm.). 

Chelidonium contains two alkaloids, chelidonine and san- 
guinarine, combined with chelidonic acid. It is a drastic 



CHARTS — CHIMAPHILA. 233 

purgative in doses of 8 to 10 grains of the extract, and has 
been used in liver disorders attended by jaundice. The 
juice of the fresh herb is irritating to the skin.] 



[Chartae. 

The officinal Papers are Charta Cantharidis, Charta 
Potassii Nitratis, and Charta Sinapis.] 



[CIIENOPODIUM— CHENOPODIUM (AMERICAN 
WORMSEED). 

The fruit of Chenopodium Ambrosiodes, Linne*, var. Anthehninticum, 
Gray (N. 0. Chenopodiacece). 

Dose, in substance, gr. xx-xl (1.30 to 2.60 Gm.). 
Officinal Preparation. 

Oleum Chenopodii. Dose for a child, gtt. v-x (.30 
to .GO Gm.). 

Internal Effects. 

A popular remedy against lumbricoid worms. It may be 
given night and morning for two or three days, then to be 
followed by a brisk cathartic] 



. [CHIMAPHILA— CHIMAPHILA (PIPSISSEWA). 

The leaves of Chhnapldla umbellata, Nuttall (N. 0. Ericaceoz). 

Officinal Preparation, U. S. 

Extraetum Chimaphila^ Fluidum. Dose, n^ xx- 
xl (1.30 to 2.60 Gm.). 

AVintergreen is an Indian remedy for scrofula, rheuma- 
tism, and nephritic affections, and in regular practice it 
enjoys some reputation as an alterative, and has been recom- 
mended as a diuretic in dropsy. It is also tonic and astrin- 
gent.] 

20* 



234 CHTNOIDIN — CHLORAL. 



[CHINOIDINUM— CHINOIDIN (QUINOIDIN). 

A mixture of alkaloids, mostly amorphous, obtained as a by-product in the 
manufacture of the crystallizable alkaloids from Cinchona.'] 



[See Cinchona ] 



[CHIRATA— CHIRATA. 

Ophelia Chirata, Griesbach (N. 0. Gentianaceoz). 

Extractum ChirataB Fluidum. Dose, n^xv-xxx 
(1. to 2. Gm.). 

Tinetura Chirata? (10 per cent.). Dose, f5i-ij (4. 
to 8. Gm.).] 

Not much used in this country. (See note under Gentian.) 



CHLORAL—CHLORAL (C 2 HC1 3 0,H 2 0-1 65.2). 

[Syn. Hydrate of Chloral. Colorless, transparent crystals, of bitterish 
caustic taste, freely soluble in alcohol or water. 

Treatment op Poisoning. 

Strychnine is the physiological antidote for chloral ; and 
the treatment must be conducted on general principles for 
narcotic poisoning, by evacuants, counter-irritants, stimu- 
lants, and maintaining bodily heat.] 

Local Action. 

Physiological. Therapeutical. 

When applied externally, It has been recommended 
chloral has been by some as an external application in 
authorities supposed to have neuralgia, rheumatism, and 
sedative properties, although other painful affections, and 
the soothing action is pre- to check itching in eczema 
ceded by some smarting and and prurigo. 
irritation; it is also an un- Used as a dressing to ulcer- 

doubted antiseptic. ated surfaces, it seems to act 

well by removing the fetor 
of discharges and lessening 
pain; and it has been success- 
fully employed, in solution, 



CHLORAL. 



235 



for the preservation of ana- 
tomical preparations, and for 
the injection of bodies, the 
only drawback to this being 
the disagreeable smell which 
results, and a certain amount 
of blackening of the tissues 
on exposure to the air. 



Constitutional Actions. 



I. Nervous System — 1. 
Brain. — Chloral [acts as a 
sedative to the nervous cen- 
tres and secondarily to the 
heart. In small doses it pro- 
bably] produces an anaemic 
condition of the brain, and 
thus causes sleep by imita- 
ting the natural anatomical 
arrangement of that process. 
The resulting slumber begins 
very quickly after the dose 
is swallowed, it is usually 
sound and dreamless, and 
the patient wakes in seven 
or eight hours, well re- 
freshed, and without any 
marked feelings of malaise, 
or digestive disturbance. 
Exceptions to this, however, 
have been observed, and in 
these chloral has caused pre- 
liminary excitement ; but it 
is more than probable that 
an explanation may be found 
in the use of the impure spe- 
cimens of the drug too often 
retailed. Liebreich believes 
that chloral exerts its hyp- 
notic influence by undergoing 
transformation in the blood 
into chloroform and formic 



I. Chloral is an excellent 
hypnotic, causing sound and 
refreshing sleep, without the 
digestive disturbance which 
usually follows the use of 
opium. It may be given in 
simple insomnia from mental 
worry, overwork, or other 
causes, and it is a remedy of 
great value in all diseases in 
which dangerous depression 
is apt to follow the continu- 
ous want of sleep. Thus, in 
typhus, in delirium tremens, 
where it must be pushed bold- 
ly in conjunction with an ab- 
solute suspension of all alco- 
hol, in phthisis, acute mania, 
etc., we may prescribe it with 
much confidence of success. 
It has also been recommended 
in France as an anaesthetic 
by intravenous injection ; 
from 2 to 4 grammes, thus 
made to enter the veins, be- 
ing there supposed to yield 
chloroform, which then ex- 
erts its usual influence. There 
is no reason, however, to be- 
lieve that anaesthesia, if thus 
produced at all which is more 
than doubtful, is in any de- 



236 



CHLORAL 



acid; but this is improbable 
for the following reasons : — 

(a) The alkali of the blood 
is too feeble to liberate the 
chloroform, and its albumen 
is considered antagonistic to 
such a process. 

(b) No smell of chloroform 
can be observed in the breath 
and no anaesthetic effect is 
produced on the sleeper by 
moderate doses. 

2. Spinal Cord. — The re- 
flex irritability of the spinal 
cord is very decidedly less- 
ened, and the respiratory cen- 
tre becomes weakened, and 
eventually paralyzed. 



3. Sympathetic and General 
Nervous System. — The vaso- 
motor system is enfeebled, 
but no special effect seems to 
be produced on other nervous 
structures, unless we believe 
a part of the loss of muscular 
power, sometimes observed in 
those who have taken chloral 
for some time, to be due to an 
action on the motor nerves. 



gree safer than the old mode 
of inhalation ; and as the pa- 
tient is thus exposed to the 
additional risks of thrombosis, 
inflammation of the veins, 
and the entrance of air, we 
cannot wonder that this pro- 
cess has found no favor in this 
country. 



2. Chloral is of service in 
some spasmodic diseases, as 
chorea,whooping-cough, asth- 
ma, incontinence of urine, 
labor after-pains, etc. It is 
also undoubtedly useful in 
[trismus nascentium, puer- 
peral convulsions, and] cases 
of tetanus even have been 
thus successfully treated on 
many occasions ; Gubler re- 
cording 36, with 21 recov- 
eries, and Chopard publishing 
80 successful cases. 

If the patient cannot swal- 
low, the drug may be used as 
enema with milk and yelk of 
egg. It may also be given 
as an antidote to strychnine. 

3. Chloral, having no in- 
fluence over sensory nerves, 
has no power, per se, of allay- 
ing pain, and is, therefore, 
useless in that class of cases 
where opium is of such signal 
service. It seems, however, 
to relieve the pain of the 
early stages of labor before 
the full dilatation of the 
os uteri. 



CHLORAL. 



237 



II. Circulatory System — 
Chloral has a powerful action 
on the heart, lowering and 
weakening its action by para- 
lyzing its contained sympa- 
thetic ganglia. That this ef- 
fect is not produced through 
the medium of the vagi is 
shown by the fact that it 
comes on even after these 
nerves are cut, and their ter- 
minal cardiac filaments para- 
lyzed by atropine. Along 
with this slowing of the pulse 
we get lessened arterial ten- 
sion from dilatation of the 
superficial vessels. [Wood 1 
considers that chloral reduces 
the excitability of the cardiac 
muscle and that it is a direct 
depressant of the heart like 
chloroform.] 

III. Respiration and Tem- 
perature The breathing 

tends to become slower, and 
finally to cease, from paraly- 
sis of the respiratory centre ; 
but urgent dyspnoea has occa- 
sionally been observed, and 
this has been ascribed to dila- 
tation of the pulmonary ves- 
sels, causing an increased af- 
flux of blood to be directed 
suddenly to the lungs. 

The temperature falls, and 
this is no doubt due to sur- 
face evaporation produced by 
the dilated cutaneous vessels. 

IV. Secreting and Diges- 
tive Systems No special in- 



II. Chloral, weakening 
cardiac action, must not be 
given where we have any rea- 
son to suspect an enfeebled 
state of the heart muscle. 
This shows how useless chlo- 
ral is likely to be as a narco- 
tic, when flaccid vessels allow 
free gravitation of blood to 
the brain during the recum- 
bent posture, thus congest- 
ing its tissues, and effectually 
preventing sleep. Its action 
is most manifest when the 
circulation is strong and the 
arteries tight. 



III. This effect on the re- 
spiratory centre naturally sug- 
gests caution in prescribing 
chloral in cases of advanced 
bronchitis with rapidly accu- 
mulating mucous secretion 
and deficient oxygenation of 
the blood. It has been much 
used in whooping-cough, but 
I have been unable to trace 
any special therapeutic effect 
beyond that to be ascribed to 
the soothing influence of 
sleep. 

It has been highly recom- 
mended as an efficient remedy 
for sea-sickness. 



1 [Therapeutics and Mater 
182.] 



Medica, 7th ed., Philada., 1SS8, p. 



238 



CHLORAL. 



fluence is produced on any of 
these, but occasionally vomit- 
ing and purging have followed 
the use of chloral. 



Absorption and Mode of Elimination. 

Chloral is rapidly absorbed by the blood, and given out 
probably by the urine, the breath, and perhaps the skin. 



Poisonous Effects. 

Chloral may kill by car- 
diac syncope, and, as this ef- 
fect has been known to follow 
a single dose of 30 grains, 
considerable caution must be 
exercised in its use, the very 
uncertainty of its action 
warning us always to feel our 
way with great care. Cases 
of recovery have been re- 
corded after quantities of 320 
and 165 grains respectively, 
but on the other hand sudden 
death has occasionally fol- 
lowed a very moderate dose ; 
or again, death may ensue 
from paralysis of the respira- 
tory centre, with coma and 
gradual suffocation ; and, fin- 
ally, a series of cases has been 
recorded in which symptoms 
arose akin to blood poisoning, 
with purpuric and scorbutic 
eruptions, ulceration of gums, 
and great prostration, ending 
in death. 



Cautions, Mode of Administration, Dose, etc. 

[It is recommended that re-crystallized chloral only should 
be prescribed, as the commercial article is liable to be con- 
taminated with impurities and the results of decomposition.] 
Liebreich holds that many of the commonly described bad 



Antidotes. 

Here our efforts must first 
be directed to obviating the 
tendency to death. We must 
endeavor to restore the heart's 
action by warmth, stimulants, 
strong coffee, and promote 
breathing by irritation of the 
surface, galvanism, and arti- 
ficial respiration ; counteract 
the rapidly lowering tempe- 
rature, on which so much 
danger depends, by warmth ; 
and finally employ physiolo- 
gical antidotes, such as atro- 
pine and strychnine. One case 
is recorded in which alarming 
symptoms, caused by taking 
370 grains, speedily yielded 
to two subcutaneous injec- 
tions of strychnine. 



CHLORAL. 239 

effects of chloral are due to impure preparations, which are 
unfortunately only too effectually masked by the syrups now 
in such general use. It is easy to detect impurity of the 
crystals, which should not be acicular in form, and cake 
chloral should always be distrusted. 

The use of chloral requires caution, as many instances of 
death from its employment are on record, and other cases 
have been noted in which very serious symptoms followed 
doses varying from 10 to 50 grains. We must also be mind- 
ful of other physiological peculiarities. Thus great muscular 
prostration, more especially affecting the legs, and causing 
staggering, not very unfrequently follows its continued use. 

Persons vary, however, in a very remarkable manner with 
regard to their susceptibility to the action of chloral, alcohol- 
ism lessening this in marked degree. Mr. Hulke {Clin. Soc. 
Trans. 1875) records a case in which a young lady, set. 23, 
took in one dose 320 grains, causing lividity, failure of re- 
spiration, weakened action of the heart, and contraction of 
the pupils, from which she was recovered with difficulty by 
the stomach-pump, artificial respiration, and strong coffee. 
Mr. Bishop, of Boston, had a case in which a patient, suf- 
fering from delirium tremens, took 165 grains, followed by 
thirty-six hours' profound sleep, and a perfect cure on 
waking. 

Prof. Gairdner met with a case of chorea in a little girl 
of eight, where 45 grains were taken by mistake, with peril- 
ous immediate consequences, but entire removal of the dis- 
ease. It is believed, on somewhat vague evidence, that 
chloral-eating is practised on a large scale with resulting 
cerebral anaemia, and moral and muscular weakness. The 
best-marked case I have yet met with is published by Mr. 
Tuflis, of the Edinburgh Asylum {Edin. Med. Journ. 1877), 
where 180 grains were regularly taken every day infrequent 
doses, causing dyspepsia, moral perversion, muscular weak- 
ness, a feeble heart, loss of memory, and epileptiform fits, 
speedily removed by withdrawal of the drug. 

Various skin eruptions, usually confined to the face, begin- 
ning as spots of roseola, coalescing to form patches of ery- 
thema, occasionally generally diffused purpuric patches, and 
the very peculiar deep flushing of the face following the use 
of stimulants, and due no doubt to vaso- motor paralysis, have 
been carefully described by Dr. Crichton Browne and other 
observers. 



240 CHLORAL 

There seems no doubt that chloral acts more powerfully in 
persons whose blood is strongly alkaline, and Prof. Kdnig 
found that the previous administration of sodium bicarbonate 
heightens the narcotic effect. In this way is explained the 
great susceptibility to the action of chloral noted by Dr. 
Russell, of Glasgow, in typhus fever. Liebreich believes it 
to act unfavorably in acute rheumatism, on account of the 
acid state of the blood. He recommends us never to give it 
on an empty stomach, nor to combine it with milk. 

Considering the undoubted fact that not only dangerous 
symptoms, but even death, have followed a dose of 30 grains 
and even of 10 grains, we must begin, as a rule, with 20 
grains or a smaller quantity, to be repeated as occasion 
requires. In labor, give one dose of gr. xv, repeated, if nec- 
essary, in two hours. We must remember, however, that the 
narcotic action of chloral is not invariably exhausted in the 
single sleep to which it originally gives rise, but it may be 
held over until next night, so that our best practice will be 
to give a full dose only once in the forty-eight hours. The 
taste and smell of chloral being pungent and disagreeable, we 
must endeavor to render our prescription as palatable as we 
can. The syrup contains 10 grains to the drachm. Or we 
may use the following formula : — 

fy. Cliloralis gr. xx ; or 1 30 Grin. 

Syrupi aurantii f 5j ; " 4 

Aq. menth. pip. q. s. ad f 3J ; " 64 

Fiat haustus hora somni suraendus. 

[The addition of gr. v of chloral to a small dose of morphine 
greatly adds to its hypnotic effect, and prevents unpleasant 
results that sometimes are produced by morphine alone.] As 
a preservative fluid for anatomical purposes we may use gr. v 
ad f Jj ; as a dressing for wounds, ulcers, and sore nippies, etc., 
gr. xv ad f^j ; in eczema, gr. lx to an ounce of lard. 

[Chloral- Camphor. By rubbing together gum cam- 
phor and chloral, a fluid is produced resembling simple syrup. 
This has been recommended as a local anaesthetic in neuralgia, 
applied with a brush to the external skin. It is rubefacient, 
but not vesicating. By the addition of this to unguentum 
an application may be conveniently and very efficiently made 
for prurigo (Bulkeley).] 

Chloral-Butylicum ; (or Croton-Butyl-Chloral Hy- 
drate.) This is a hydrate of trichorbutylaldehyd made by 



CHLORAL. 



241 



the action of chlorine upon acetic aldehyde and distillation. 
It is not officinal. The name of Butyl Chloral, advised by 
Liebreich, would be an improvement, as preventing the idea 
of any relationship to croton oil. Dose, gr. iij to x (.20 to 
.60 Gm.) 

Local Action. 
None has been described, 



Constitutional Action. 
Physiological. Therapeutical. 



I. Nervous System. — 1. 

Brain Butyl-chloral causes 

sleep in from fifteen to twenty 
minutes. 

[It is better to administer 
it in glycerine and water, than 
in alcohol.] 



2. Spinal Cord No ac- 
tion is produced on the spinal 
cord, nor consequent muscu- 
lar relaxation. Some para- 
lyzing influence is eventually 
excited on the medulla. 

3. Sympathetic and other 
Nervous Systems. — No influ- 
ence seems to be exerted on 
the vaso-motor nerves, but on 
the fifth a well-marked seda- 
tive effect is noted, indicated 
by anesthesia of the head and 
face, loss of irritability of the 
eyeball, and failure of the 
nerve-trunk itself to respond 
to galvanic stimulation. 

II. Circulation. — Butyl- 
chloral has physiologically 
less tendency than chloral- 
21 



1. Butyl-chloral has been 
highly praised by its disco- 
verer, Liebreich, as a nar- 
cotic, being given by him in 
doses of from 15 to 30 grains 
(1. to 2. Gm.). There is 
little English experience to 
quote on this heading, as the 
doses used here are far too 
small to produce sleep. 



3. The anaesthetic influ- 
ence of butyl-chloral would 
naturally suggest its use in 
facial neuralgia, and a good 
deal of success has been thus 
obtained in dealing with this 
troublesome affection, doses 
of from 2 to 6 grains having 
generally been prescribed. 



II. Experience has shown 
it to be an uncertain remedy, 
and dangerous and even fatal 



242 CHLOROFORM. 

hydrate to weaken or lower symptoms have followed ordi- 
the action of the heart. nary doses in organic heart 

disease. 
III. Respiration and Tern- [III. Butyl- chloral closely 
perature. — Butyl - chloral resembles chloral hydrate in 
tends to lower the rate of its action upon the system, 
breathing, and eventually except in possessing greater 
kills by paralyzing the respi- danger. For this cause its 
ratory centre. use has been almost entirely 

discontinued in this country.] 



[CHLOROFORMUM VENALE— COMMERCIAL 
CHLOROFORM (CHC1 3 — 119.2). 

A liquid containing at least 98 per cent, of Chloroform.] 



[CHLOROFORMUM PURIFICATUM (PURIFIED 
CHLOROFORM). 

{A heavy, clear, colorless, diffusive liqitid of a characteristic, pleasant, 
ethereal odor, a burning, siveet taste, and a neutral reaction.) 

Dose, n^x-xxx (.65 to 1.30 Gm.) largely diluted. 

Officinal Preparations, U. S. 

Mistura Chloroformi (chloroform 8, camphor 2, frjsh 
yelk of egg 10, and water 80). Dose, f^ss (16. Gm.). 

Spiritus Chloroformi 1 (10 per cent.). Dose, i5 ss j 
(2. to 4. Gm.). 

Linimentum Chloroformi (commercial chloroform, 
40 ; soap liniment, 60). External use. 

It is used in the manufacture of Liquor Gutta-Perchas, and 
in preparing Atropine. 

Poisoning. 

If, during chloroform- narcosis, there is failure of the cir- 
culation, vigorous and prompt measures are called for. Ni- 
trite of amy! should be administered (gtt. iij-v) by inhalation. 
The surface of the chest should be smartly slapped with the 
fringe of a towel dipped in ice-water, a piece of ice may be 

1 [Spiritus Chloroformi, Br., contains one part in twenty.] 



CHLOROFORM 



243 



introduced into the rectum, the head must be lowered and 
the legs elevated, and ammonia held to the nose ; an assistant 
meanwhile practising artificial respiration. This treatment 
the late Prof. Gross claimed to be invariably effective, as 
by resorting to it he had not lost a patient out of more than 
5000 cases of chloroform-anaesthesia.] 

Local Action. 



Physiological. 

Chloroform, when allow r ed 
to remain for some time in 
contact with the skin, acts as 
an irritant, causing redness 
and smarting, followed by 
vesication. 

It has also, however, some 
sedative properties. 

Chloroform is an excellent 
solvent of caoutchouc, gutta- 
percha, and many fats and 
resins. 



Therapeutical. 

The locally sedative action 
of chloroform has led to its 
extensive use as an applica- 
tion for the relief of rheuma- 
tic or neuralgic pains, t lie 
liniment being a convenient 
form. 

It is also a useful remedy 
for allaying the itching of 
some chronic forms of skin 
disease. 

Gutta-percha dissolved in 
chloroform to saturation is an 
excellent application in small- 
pox and erysipelas. 



Constitutional Action. 



Chloroform, when taken 
internally, may act as a stim- 
ulant, sedative, and anti- 
spasmodic. 



It is a useful remedy in 
hysteria, asthma, and nervous 
palpitation, for the arrest of 
sea-sickness and other forms 
of vomiting, and for the 
soothing and quieting of some 
forms of irritable cough. 



Combined Local and Constitutional Effect. 

Under this heading it may be convenient to discuss the 
anaesthetic properties of chloroform, and this we will now 
proceed to do on the plan adopted generally throughout these 
pages. 



244 



CHLOROFORM 



Physiological. 

1. On Brain and Nervous 
System. — Chloroform has 
first a stimulating, and sec- 
ondly a sedative, action on 
the brain, a good deal of ex- 
citement and struggling tak- 
ing piace during the early 
stages of inhalation, whilst, 
during the later, narcosis is 
complete, and the patient lies 
quiet and motionless. This 
condition resembles natural 
sleep in being associated with 
anaemia of the brain, but dif- 
fers by its rendering the pa- 
tient quite insensible to ex- 
ternal impressions, including 
the most severe cutting opera- 
tions, this effect being due to 
a paralyzing influence of the 
drug on the ganglionic centres 
of the sensory nerves. 

The reflex functions of the 
cord are also lulled to slum- 
ber, and, if the inhalation is 
pushed too far, paralysis of 
the respiratory centre may 
ensue. Its inhalation under 
certain circumstances is apt 
to excite erotic sensations in 
women, and to lead them to 
bring unfounded accusations 
against medical men. 

2. Heart and Circulation. 
— On the heart the influence 
of chloroform is at first 
slightly stimulating, the pulse 
becoming quickened ; but 
secondary depression follows 
from a paralyzing influence 
on the sympathetic ganglia, 



Therapeutical. 

1. In the early stage of 
inhalation the patient usually 
feels confused and giddy, his 
eyes are suffused, his face 
congested, and the heart 
beats rapidly. This is often 
followed by apparent insen- 
sibility, from which, how- 
ever, he can readily be roused, 
and very frequently a stage 
of violent excitement ensues, 
during which he struggles 
violently and with remarkable 
muscular force, talking and 
singing incoherently mean- 
while. This stage has been 
compared with that of alco- 
holic intoxication. Succeed- 
ing to this we have that of 
" anaesthesia," in which he is 
profoundly insensible, with 
contracted pupils ; and finally 
we reach that of " narcosis," 
in which the face becomes 
congested, the pupils dilate, 
and stertorous breathing sets 
in. Chloroform inhalation is 
only used during its first stage 
to alleviate the pain of child- 
birth, it being found that 
full anaesthesia under these 
circumstances is apt to relax 
the uterine muscular tissues, 
and not only to check their 
contraction, but to predispose 
to future hemorrhage. 

During the second stage, 
chloroform is used for the 
purpose of obtaining full and 
complete insensibility to pain 
during the performance of 



CHLOROFORM. 



245 



tlie pulse now growing 
slower, and the arterial ten- 
sion becoming lowered. 

3. Respiration and Tem- 
perature. — The respiration 
tends at first towards in- 
creased rapidity, but if the 
inhalation is pushed so far as 
to affect the respiratory cen- 
tre, the breathing grows 
slower and finally ceases. 
[It may cease suddenly with- 
out warning; and there is no 
means of determining pre- 
viously, at least with our pre- 
sent knowledge, when this 
accident will occur, or what 
patients are particularly liable 
to it. This is the great ob- 
jection to chloroform.] We 
usually observe some tend- 
ency to perspiration attend- 
ing chloroform inhalation, 
and a consequent slight re- 
duction of temperature. 

4. On the digestive and 
secreting organs chloroform 
seems to exert no marked 
influence, the sickness so fre- 
quently observed during re- 
covery being purely reflex in 
character. 



operations ; and this invalu- 
able property has deprived 
the practice of surgery of 
much of its former horrors. 

We also employ it freely 
to relax muscular tension 
and spasms, and so facilitate 
the reduction of hernia and 
dislocation ; for diagnostic 
purposes, in order to dispel 
phantom uterine tumors, as 
well as to enable us to make 
a careful examination of ex- 
tremely painful parts. 

Jt is also of service for 
the relief of various forms 
of spasmodic affections, as 
whooping - cough, infantile 
and puerperal convulsions, 
chorea; and to alleviate pain, 
in cancer, during the passage 
of renal or biliary calculi, 
and under many other condi- 
tions. 



Poisonous Properties. 



Chloroform may kill in 
two ways. (1) By primarily 
paralyzing the heart, and this 
has generally been considered 
to be due to the inhalation 
of air too highly charged with 
chloroform vapor, Mr. Clo- 
ver holding that over 5 per 

2 



During chloroform-inhala- 
tions we must watch the pulse, 
and specially note enfeeble- 
ment, irregularity, or cessa- 
tion of its beats. Sudden 
pallor of the face, lividity 
and gasping for breath are 
signs of ill omen. If the 
1* 



246 



CHLOROFORM. 



cent, must be considered 
dangerous. Dr. Brunton, 
however, explains very inge- 
niously how it is that small 
doses are more apt to produce 
this effect than large, and 
why it is that deaths gene- 
rally occur during imperfect 
narcosis. He points out that 
under these conditions the 
reflex contraction of the ves- 
sels is destroyed, whilst the 
heart is stopped or slowed, so 
that the irritation of a sensory 
nerve may produce syncope 
by stopping the supply of 
blood from the heart, while 
the blood still flows rapidly 
from ihe arterial system 
through the capillaries into 



the 



When the 



anaesthesia is complete, both 
reflexes are paralyzed and 
circulation remains unaffect- 
ed by any impression made 
upon the sensory nerves. 

It seems highly probable, 
however, that, in accordance 
with the views of Syme, Lis- 
ter, Chiene, etc., fatal acci- 
dents from chloroform are 
not so liable to proceed from 
the heart as (2) from the 
respiratory function ; and this 
mode of fatal accident has 
been again subdivided into 
two headings : 1st. Death by 
apncea, or stoppage of the 
breathing from nervous in- 
fluence or mechanical causes ; 



action of the heart seems to 
fail, we must administer 
stimulants by the mouth or 
rectum, and excite the cuta- 
neous surface. Galvanism 
seems more likely to exhaust 
than excite the contractility 
of the heart muscle ; and 
galvano-puncture, so much 
vaunted by foreign observers, 
has not been tried in this 
country. 



Chloroform accidents de- 
pending, in a great majority 
of cases, on failure of respi- 
ration, we must endeavor to 
re-excite this function by 
cold sprinkling, or ammonia 
vapor, but, most hopefully, by 
the steady and persevering 
use of artificial respiration. 
Always, however, see that 
no mechanical hindrance to 
breathing exists, and more 
especially take care to draw 
the tongue well forward ; 



1 [If this were true, there should be more deaths from heart-fail- 
ure under ether than chloroform, because ether is more irritating 
to the upper air-passages than chloroform.] 



CHLOROFORM. 



24? 



or, 2dly, by suffocation, from 
excessive formation of car- 
bonic acid in the blood. Of 
these, the first is by far the 
more common, and is often 
caused by falling back of the 
tongue, or by paralysis of the 
intrinsic muscles of the 
larynx, closing the glottis. 
It therefore follows that, 
whilst engaged in the admin- 
istration of chloroform, the 
breathing must be very care- 
fully watched. [The densi- 
ty of chloroform vapor being 
much greater than atmo- 
spheric air, if given freely and 
without proper dilution, it 
may cause suffocation direct- 
ly, by filling the air-cells and 
excluding oxygen, owing to 
the difficulty of diffusion of 
such a heavy vapor. This 
may explain the utility of 
JS'elaton's method, which has 
been followed by such suc- 
cessful results in threatened 
death from chloroform. 1 ] 



this little operation acting 
not only by removing its own 
mechanical impediment to 
breathing, but by drawing and 
pulling the epiglottis forward, 
and thus opening the glottis 
by the traction made on the 
aryteno-epiglottidean mus- 
cles. 

The same object may be 
attained by raising the chin 
and drawing it forcibly away 
from the spine. 

Galvanic stimulation of the 
phrenic nerve has been re- 
commended, and several ap- 
parently hopeless cases have 
been saved by the process of 
inversion as originally pro- 
posed by Nelaton. 

The inhalation of nitrite of 
amyl has also been recom- 
mended as averting the as- 
phyxia of pulmonary stasis, 
and tracheotomy has been 
successful in some apparent- 
ly hopeless cases. 



Absorption and Elimination. 

Chloroform is rapidly absorbed and rapidly given off by 
the breath and urine, in which secretion it can be readily 
detected. 

Mode of Administration. 

Fatal accidents from chloroform have become so alarm- 
ingly frequent of late — the total number, according to Bartho- 
low, amounting to 500 — that some surgeons even consider 
its use unjustifiable ; but it is on the whole the best anaes- 
thetic, and, by adopting the following precautions, we may 



1 [See paper on the Physics of Anze'stheties, by Dr. Wm. H. 
Greene, in the Am.Jonm. of Med. Sci. for April, 18S2.] 



248 CHLOROFORM. 

hope to imitate the success of the Edinburgh School, where 
danger or inconvenience rarely occurs, Mr. Syme having 
met with no death during 8000 administrations. [Prof. 
Fraser, of Edinburgh, advises the subcutaneous injection, 
fifteen or twenty minutes before chloroform is begun, of t ^q 
to ^L g r . of atropine combined with gr. -^ to gr. -| of hydro- 
chlorate of morphine, with the object of stimulating the heart, 
obviating nervousness, and lessening or altogether preventing 
subsequent sickness.] 

1. Never permit inhalation to take place in a sitting pos- 
ture, and see that the patient's neck is free from all con- 
striction. 

2. Give strict orders that no solid meal be taken for at 
least two or three hours previously [solid food should not be 
eaten for at least twelve hours, as a safe precaution], but a 
little beef-tea may be allowed, and a small sip of brandy is 
useful just before the operation. The sickness which so fre- 
quently attends a loaded stomach is not only inconvenient, 
but has proved fatal by suffocation from the drawing of 
vomited matters into the air-passages. And, in addition to 
this danger, vomiting is attended with special risks after 
such operations as ovariotomy and cataract extraction, and 
after the first of these it occasionally continues with exhaust- 
ing pertinacity. 

3. Use no special form of inhaler, but pour the chloro- 
form upon a towel or other porous material, and give it with 
care [allowing free admixture of the vapor with sufficient 
atmospheric air]. Tell the patient to close his eyes and to 
inspire deeply, and when the period of excitement comes on 
do not suspend the inhalation. Complete anaesthesia is 
proved by the abolition of reflex action, as shown by insen- 
sibility of the eye when the cornea is lightly touched with the 
finger, by muscular relaxation, and by insensibility to pain. 

[4. If the action of the heart seems to fail, remove the 
chloroform and administer ether vapor for a few respirations. 
Do not give anything by the mouth. If the respiration be 
languid and intermit, assist the movements by gentle pres- 
sure on the chest and abdomen. If the natural respiration 
has ceased and the pulse is not distinctly felt, at'once resort 
to the more effective artificial respiration of Marshall Hall 
or Howard. Warmth should also be applied by the readiest 
means; galvanism, etc.- C] 

When the operation is over, let the patient recover natu- 



CHLOROFORM. 249 

rally, and do not disturb his sleep by the purposeless towel 
flickings so frequently to be seen in operating theatres. But 
the patient should be carefully watched for at least an hour 
after administration. 

As regards the quantity of chloroform to be used for each 
inhalation, it is impossible to lay down any rule, for the in- 
conveniences occasionally met with seem to bear no sort of 
proportion to the dose of the anaesthetic. [A couple of 
drachms may be poured from a dropping bottle upon the 
towel, and a few drops added from time to time to replace 
loss by evaporation. The chloroform should never be trusted 
to any but a skilled assistant.] If the chloroform be of good 
quality, it is safer, as shown by Brunton, to give it freely, 1 
and it is better to trust to our own care and skill than to the 
fancied safety of inhalers. It can never be possible to de- 
prive an unnatural condition like profound anaesthesia of all 
dangers, and even the theoretically safe instrument of Clo- 
ver, with its guaranteed 3 per cent, of chloroform vapor, has 
been shown to be not absolutely free from risks. 2 

It would be very satisfactory could we lay down any laws 
for our guidance in anticipating danger from chloroform in- 
halation in any special class of cases, but this unfortunately 
vv, cannot do. It is now well known that neither organic 
disease of the heart nor conditions of extreme debility are 
contra-indications ; and although fatty heart is frequently 
discovered post mortem, we cannot absolutely state that this 
is not a mere coincidence, nor can we pretend to diagnosti- 
cate such degeneration with any certainty during life. Some 
authorities believe that chloroform is more dangerous to the 
old than the middle-aged or young, and there seems no doubt 
that habitual topers are brought under its influence with con- 
siderable difficulty. 

It may be very pleasantly combined with cardamom, in 

[* Surely Brunton's views hardly warrant so much indifference 
to the dose of chloroform. The tendency to syncope is found to be 
in proportion to the strength of the vapor, whenever, by opening 
the windpipe, we make sure of its entrance into the lungs. Ten 
per cent, of chloroform vapor, given in this way, is rapidly fatal 
by arresting the heart's movement. The reason why chloroform 
has often been fatal in minor operations is, that it so often happens 
an extra dose is given that it may last long enough without further 
attention from the surgeon. C] 

[ 2 I am not acquainted with any case in which so little as 3 per 
cent, has been fatal to the human subject. C] 



250 CHONDRUS — CHRYSAROBIN. 

doses of from n^x to 3J ; or we may make a good emulsion 
with 20 minims in ^j of milk. The P. Br. has now intro- 
duced the tinctura chloroform! et morphinse, a very com- 
plex preparation, containing, in addition to the principal 
ingredients, ether, prussic acid, peppermint, treacle, liquor- 
ice and syrup [chlorodyne]. Dose, 5 to 10 minims. 

Chloroform is most generally given internally under the 
form of the spiritus chloroformi, or chloric ether, or as mis- 
tura chloroformi. [For the remarks of Mr. Clover upon the 
choice of anaesthetics, see page 59.] 



[CHONDRUS— CHONDRUS (IRISH MOSS). 

Chondrus crispus, Lyngbye, and Ckondrus mammillosus, Greville (iV. 
0. Algaz), bleached and dried by exposure to the sun. 

Carrageen is demulcent and nutritive, and is used in de- 
coction (3ss to Oiij) flavored with lemon, as a tisane or 
drink for the sick. Boiled with milk it makes carrageen 
blanc mange, an acceptable and nourishing article of diet for 
an invalid.] 

CHRYSAROBINUM— CHRYSAROBIN. 

[A mixture of proximate principles, commonly misnamed Chrysophanic 
Acid, extracted from Goa- Powder, a substance found deposited in the 
wood of the trunk of Andira Araroba, Aguiar (N. 0. Leguminosie, 
Papiltonaceoz). 

Officinal Preparation. 

Unguentum Chrysarobini (10 per ct., with ben- 
zoinated lard 90 per ct.). External use.] 

Goa-Powder has been extensively used in cases of ring- 
worm and psoriasis. 

There is no doubt, as I have amply verified by my own 
experience, that chrysarobin, although not the infallible 
specific it was originally supposed to be, is a very useful 
remedy in psoriasis, and the various forms of tinea. Its 
drawbacks are — 

1st. The irritation it often excites. This may either be 
in the form of a papular eruption, or of an inflammatory 
condition closely allied to erysipelas, frequently spreading 
over the head and face, and attended by most distressing 
smarting and tingling. 



CIMICIFUGA — CINCffONA. 251 

2d. The peculiar purplish discoloration of the skin which 
it causes, and which is only removed by the desquamation 
of the cuticle which usually follows. 

3d. The way in which it stains linen — the discoloration, 
however, disappearing after the use of bleaching-powder. 



CIMICIFUGA— CIMICIFUGA (BLACK SNAKE- 
ROOT). 

[The rhizome and rootlets of Cimicifuga racemosa, Elliott (N. 0. Ra- 
nunculacece.) 

Officinal Preparations, U. S. 

Extraetum Cimicifugae Fluidum. Dose, i$ss-j 
(2. to 4 Gm.). 

Tinetura Cimieifugse (20 per ct.). Dose, fjj-iij 
(4. to 12. Gm.). 

The decoction, although not officinal, has been used to a 
considerable extent, and with benefit, in the treatment of 
chorea in children. It is sedative and antispasmodic, and 
in large doses vomits.] 

This drug was introduced into practice in this country 
[England] some years ago by Sir J. Simpson, who praised 
it highly in chronic rheumatism, lumbago, and hypochon- 
driacal depression. It has been found useful in America as 
an emmenagogue, but has never taken any real hold upon 
professional attention at home. 



CINCHONA—CINCHONA. 

[The bark of any species of Cinchona (N. 0. Rubiaceai, Cinchoneoe) 
containing at least three per cent, of its peculiar alkaloids. 

Officinal Preparation. 

Infusum Cinchonas (of yellow cinchona, except 
when some other variety is specified, 6 parts, aromatic sul- 
phuric acid 1 part, water a sufficient quantity to make 100 
parts). Dose, fgj-ij (.32 to .64 Gm.).] 



252 CINCHONA. 



CINCHONA FLAVA—YELLOW CINCHONA. 

[ The bark of the trunk of Cinchona Calisaya (Weddell), containing at 
least 2 per cent, of quinine.] 



CINCHONA RUBRA— RED CINCHONA. 

[ The bark of the trunk of Cinchona Succirubra (Pavon), containing at 
least 2 per cent, of quinine. 

Officinal Preparations, U. S. 

Of the Yellow Bark :— 

Extraetum Cinchonse. Dose, gr. v-xv (.30 to 1. 
Grin.). 

Extraetum Cinchonee Fluidum. Dose, gtt. v-xxx 
(.30 to 2. Gm.). 

Infusum Cinchona? (except when otherwise specified). 
Dose, f£ij (64 Gm.). 

Tinetura Cinchona? (20 per cent.). Dose, f"3j-ij 
(4. to 8. Gm.). 

Of the Red Bark :— . 

Tinetura Cinchonas Composita (Cinchona, Gly- 
cerin, aa 10; Bitter Orange Peel, 8; Serpentaria, 2; Al- 
cohol to 100 (Huxham's tincture). Dose, f3j-ij (4. to 8. 
Gm.). 

The officinal Alkaloids and Alkaloidal Salts of Cinchona 
are as follows : 

Cinehonidina? Sulphas (white silky needles soluble 
in 100 parts of water, and 71 parts of alcohol ; odorless, with 
very bitter taste). Dose, gr. v-xxx (.30 to 2. Gm.). 

Cinehonina (white crystals, almost insoluble in water, 
at first tasteless and then bitter, has an alkaline reaction). 
Dose, gr. v-xxx (.30 to 2. Gm.). 

Cinehonina^ Sulphas (white needles, soluble in 70 
parts of water, and in 8 parts of alcohol ; very bitter taste). 
Dose, gr. v-xxx (.30 to 2. Gm.). 

Quinidina? Sulphas (white needles, soluble in 100 
parts of water, and in 8 parts of alcohol ; very bitter taste). 
Dose, gr. v-xxx (.30 to 2. Gm.). 

Quinina (a white amorphous powder, soluble in 1600 
parts of water, and in 6 parts of alcohol ; very bitter). 
Dose, grs. i-3j (.06 to 4. Gm.). 



CINCHONA. 253 

Quininae Bisulphas. Dose, grs. i-lx (.06 to 4. Gm.). 
" Hydrobromas. " " " " " 
" Hydrochloras. " " " " " 
" Sulphas. " " " « " 

" Valerianas. Dose, grs. i to xx (.06 to 1 .30 Gm.). 
Chinoidinum (a mixture of alkaloids mostly amor- 
phous, obtained as a by-product in the manufacture of the 
crystallizable salts). Dose, gr. ij-xx (.12 to 30. Gm.).] 

Effects and Uses. 

In any comparative estimate of the absolute importance 
of various drugs to the human species, cinchona would 
probably take the second place, the first being, by universal 
consent, accorded to opium. The bark itself, however, is 
not now of so much importance as in former years, when it 
was our sole dependable remedy for the poison of ague, and 
was then given in such enormous quantities as to be very 
embarrassing to the weak stomachs of feverish patients. 
This difficulty is now happily removed, and much greater 
precision and efficiency given to our treatment, by the intro- 
duction of quinine, the discovery of which in 1820 inaugu- 
rated a true era in therapeutics. 

The preparations of cinchona are now used almost exclu- 
sively on account of their tonic properties, and in many cases 
of general debility, want of appetite, and loss of tone, most 
gratifying results are obtained by their employment either 
singly or in combination. Quinine itself, however, has a 
higher and wider therapeutic range, and has in recent years 
obtained so much of the careful attention of physiologists 
that we are bound to consider its properties with as much 
care and precision as the present state of science allows. 

Local Action. 

Quinine is occasionally, although rarely, used as a local 
application ; but the theory of this is so intimately bound up 
with its internal use, that we need not refer specially to it at 
present, save to note that an injection of gr. ij ad §j has 
been found of great service in checking the unhealthy secre- 
tion of an irritable bladder. [It is antiseptic] 
22 



254 



CINCHONA. 



Internal Action. 
Physiological. Therapeutical. 



1. Nervous System. — 1. 

Brain Quinine in large 

doses causes curious brain 
symptoms, such as partial 
blindness, well-marked deaf- 
ness and ringing in the ears, 
giddiness, and frontal head- 
ache, associated with a pecu- 
liarly dull, heavy expression 
of countenance. Binz has 
suggested that some at least 
of these phenomena may be 
due to partial anaemia of the 
brain, caused by enfeebled 
action of the heart. Ham- 
mond, on the contrary, as- 
serts that quinine causes con- 
gestion of the brain. Gubler 
asserts that it stimulates the 
great sympathetic and audi- 
tory nerves. 

It contracts the uterus. 

2. Spinal System In 

frogs, quinine acts powerfully 
in reducing the reflex irrita- 
bility of the cord, the animal 
lying motionless, quite insen- 
sible to external impressions, 
the stillness being only 
broken by occasional tetanic 
spasms ; but this action is 
contradicted by the more re- 
cent experiments of Binz. 

II. On Vascular System. 
— Moderate doses of quinine 
increase the frequency of the 



I. The subcutaneous injec- 
tion of quinine has been 
highly recommended by Sur- 
geon-Major Hall in sun- 
stroke. 

This mode of administer- 
ing the drug, however, is not 
unfrequently followed by in- 
flammation and even abscess 
at the seat of puncture. 
Gubler prefers the brom- 
hydrate to the sulphate, as 
being less irritating and bet- 
ter adapted for use in this 
way. 1 

The oxytocic action of qui- 
nine must be, in part at least, 
due to its action on the ner- 
vous system ; but its un- 
doubted power in contracting 
the uterus has not yet been 
much used in medicine. [It 
appears to be appreciated in 
the United States. Here it 
is frequently used as a par- 
turifacient in single doses of 
gr. x-xv.] It has, however, 
been asserted that it may be 
injurious to the foetus. 



II. Quinine has therefore 
some stimulating properties. 
It has been shown to be a 



[ l A hypodermic injection of sulphate of quinine has caused 
tetanus. Possibly, an unclean syringe was responsible, as it is 
for abscesses after hypodermic injection.] 



CINCHONA. 



255 



pulse, but, if larger quantities 
be given, the rate of pulsa- 
tion falls, the arterial tension 
diminishes, and death may 
even ensue from convulsions 
or sudden collapse following 
depression of the heart's ac- 
tion. 

Quinine has a direct action 
on the white corpuscles of the 
blood, checking their amoe- 
boid movements, and arrest- 
ing their tendency to migrate 
through the walls of the ca- 
pillaries under inflammatory 
conditions. 

It also prevents, in some 
degree, the due giving up of 
oxygen by the red corpuscles, 
and may thus interfere with 
the oxygenation of the tissues. 

III. Respiration and Tem- 
perature No influence on 

the respiratory function has 
been observed. On the tem- 
perature of a person in full 
health but little lowering 
effect is produced ; when fever 
is present, however, the tem- 
perature may be brought 
down by giving large doses. 
Opinions differ so much as 
to the explanation of this 
effect, that it is impossible to 
speak with any confidence on 
the question. [According to 
Henbach, the cause of death 
in animals poisoned with 
quinine is a paralytic arrest 
of respiration.] 



valuable remedy in 8 to 15 
grain doses, in combination 
with potassium iodide in cases 
of specific and non-specific 
serpiginous and phagedenic 
ulceration, after the failure of 
other remedies. Very large 
doses seem to be well borne 
in pyrexial conditions. 

An essential part of in- 
flammation and suppuration 
is now known to be extrusion 
of the white blood corpuscles 
from the capillaries, and their 
subsequent transformation in- 
to pus-cells. Quinine may 
therefore be of great service 
in localized inflammations, 
and in checking exhausting 
discharges from abscesses or 
wounds, and in pyaemia good 
results have followed its use. 

III. The antipyretic pro- 
perties of quinine are much 
prized in Germany, and it is 
there largely used in the 
treatment of typhus, typhoid, 
acute rheumatism, and pneu- 
monia. 

Immense doses, even reach- 
ing 75 grains, have been 
given, and it is observed that 
tolerance of the drug is un- 
doubtedly present in fever, 
and that very much larger 
quantities can be taken than 
in a state of health. It is 
only when very freely given, 
however, that it has any cool- 
ing influence ; and we are 
advised to prescribe from 25 
to 45 grains in divided doses 
within the first half hour, and 



256 CINCHONA. 



then allow an intermission of 
from 24 to 48 hours, as the 
effect would be diminished 
by spreading it over a longer 
time, on account of its rapid 
elimination. On account of 
this rapid elimination Lieber- 
meister considered it even a 
more valuable antipyretic 
than the cold bath. 

In this country we do not 
make very extensive use of 
quinine in febrile disorders, 
for the resulting diminution 
of temperature is only tem- 
porary, and has no influence 
on the progress of the dis- 
ease. When a really dan- 
gerous degree of pyrexia is 
reached, we know that we 
can hold it readily in check 
by cold baths. 

A committee of the Clini- 
cal Society reported (vol. iii.) 
on the antipyretic action of 
quinine, finding that large 
doses reduce temperature in 
pyrexia when given towards 
the end of the exacerbation 
or during the remission. It 
seems, however, to have no 
influence in shortening the 
duration of a specific disease. 

They advise a single large 
dose, followed by an intermis- 
sion of from 24 to 48 hours. 
Ringing i n the ears was occa- 
sionally observed, but other 
physiological results were ex- 
tremely rare. Dr. Clifford 
Allbutt finds quinine of use 
in septic fevers, such as py- 
aemia, septic absorption, ery- 



CINCHONA. 



257 



IV. On Secretion. — In 
moderate doses, quinine in- 
creases the secretion of sa- 
liva, and augments, like most 
bitters, the flow of gastric 
juice, stimulating the appe- 
tite at the same time. 

If larger quantities, how- 
ever, are taken, an exactly 
opposite effect is produced; 
hunger is blunted, and the 
alkaloid, acting as an irritant 
to the mucous membrane of 
the stomach, checks the gas- 
tric juice. The urine is found 
to be unaltered in quantity, 
but the amount of uric acid 
and probably of urea given 
off is decidedly diminished. 

V. Quinine is an excellent 
antiseptic, preventing and ar- 
resting decomposition. This 
it does in virtue of its poison- 
ous influence over minute or- 
ganisms, for we know that the 
process of decay is caused by 
the formation and rapid mul- 
tiplication, within the putre- 
fying fluid, of microscopic 
bodies called microzymes. 
Quinine in small doses para- 
lyzes, and in larger, destroys, 
these creatures, and so at 
once arrests further destruc- 
tive action. 



sipelas, peritonitis, &c, re- 
ducing the oscillations of tem- 
perature, but not relieving 
the general conditions. Dose 
from 20 to 60 gr. daily. He 
holds it to be not only use- 
less, but possibly injurious in 
typhoid. 

IV. Quinine is the best 
tonic we possess, increasing 
the appetite, and bracing up 
the intestinal mucous mem- 
brane. It is given, therefore, 
in all states of the system 
where debility is present, in 
simple loss of appetite, in 
some forms of dyspepsia, in 
neuralgia, especially of the 
supra-orbital nerve, in conva- 
lescence from acute disease, 
to arrest the nocturnal sic eat- 
ing of phthisis, etc. 



V. In virtue of this poison- 
ous influence over protoplasm 
and minute germs, it has been 
recommended in large doses 
in whooping-cough, on the 
ground of destroying the vi- 
tality of the thick and tena- 
cious mucus which causes so 
much irritation in the bron- 
chial tubes, or, as others hold, 
by destroying the minute fun- 
gus on which the disease de- 
pends. [Henke.] During the 
later stages of the disease 
much benefit is derived from 
this treatment. Again, in 



39* 



258 



CINCHONA. 



hay-fever, which is now prov- 
ed to result from the local 
action on the Schneiderian 
mucous membrane of the 
pollen of particular grasses, 
Prof. Helmholtz has lately 
pointed out that quinine ap- 
plied in the form of snuff or 
weak solution [gr. j-f^j], 
will effect a speedy cure. 



Some authorities have been 
inclined to explain its remark- 
able influence over ague by 
theoretically supposing that 
the essence of the malarial 
poison really consists in a 
minute germ or vegetable cell 
derived from the marshy land 
where the pestilence breeds, 
and that the antiseptic prop- 
erty of the drug is here the 
true explanation of its thera- 
peutic success. 

This seems to be borne out 
by the recent observations of 
Lanzi and Zerner, who have 
found an identical fungus in 
the decaying vegetation of 
the Roman Campana and in 
the tissues of the victims to 
malaria. 

Specific Action. 

Quinine has what, for want of a better explanation, we 
must call a specific control over all malarial fevers and dis- 
eases which display any periodical tendency. Gubler, how- 
ever, denies all specific influence, and believes that it acts by 
giving tone to the sympathetic nerve, thus enabling it to re- 
sist the attack of the malarial poison. Binz, on the con- 
trary, denies all neurotic explanations and holds its effects to 
be due to its paralyzing action on the septic processes caused 
in the blood and tissues by a ferment from decaying vege- 
tation, whose further chemical development is thus arrested. 

Quinine may act as a prophylactic, and, given in moderate 
doses at regular intervals, may ward off attacks ; and this 
fact is extensively taken advantage of by African travellers 
and troops stationed in malarial districts, to whom rations of 
quinine are invariably served out. When the disease, how- 
ever, is fairly developed, quinine will keep it in check and 
even arrest its progress ; and this either in smaller doses fre- 
quently repeated, or in one considerable dose taken shortly 
before the attack is expected. 

The periodical return of the paroxysms of shivering, heat, 



CINCHONA. 259 

and sweating, enables us to calculate with accuracy the very 
hour of the day at which to expect their recurrence ; and 
experience has determined that the best mode of treatment 
is to give one full dose of 10 or 20 grains four or five hours 
before the attack comes on. 

The remarkable enlargement of the spleen which attends 
intermittent fever is often so rapidly diminished by quinine 
as to make it probable that the reduction of bulk is due to an 
active contraction of the substance of the organ itself. 

Another curious point about the action of quinine is, that 
whilst it may check the rigors and rise of temperature attend- 
ing the aguish paroxysm, the quantity of urinary water and 
urea excreted may be as much increased as they always are 
during the attack. 

Quinine is also an invaluable agent in some of those affec- 
tions which, without belonging directly to the aguish cate- 
gory, have something of the intermittent quality impressed 
on them ; for example, we often find that neuralgia and 
various forms of headache are distinctly periodic, and return 
at regular intervals. In such cases quinine works wonders 
and may effect a cure with almost magical rapidity. 

Mode of Elimination. 

Quinine, being possessed of considerable diffusive power, 
rapidly enters the blood, and is rapidly given out. It may 
be found in the urine in 30 minutes after ingestion ; elimina- 
tion is at its height in 2 or 3 hours, diminishes in 24 hours, 
and ceases in three days. Although traces of its presence 
have been found in the saliva, sweat, and intestinal secre- 
tion, it is by the urine that the greater part, probably about 
two-thirds, is given off, and, according to some authorities, 
the quinine is converted into a different allotropic form, 
partly amorphous, and quite inert, which has been called 
quinicine. 

Disadvantages of its Use. 

In addition to the headache, deafness, ringing in the ears, 
and other physiological phenomena, already noted, a good 
many cases have now been recorded of eruptions on the 
skin. In some of the quinine manufactories abroad, ecze- 
matous eruptions are observed in the workmen employed, 
and its internal administration has been occasionally fol- 



260 CINCHONA. 

lowed by a bright-red, scarlatinoid rash, accompanied by- 
intolerable itching and smarting and followed by copious des- 
quamation, or, more rarely, by a rubeoloid eruption, rather 
suggestive of urticaria, and attended with marked gastric 
derangement, a curious point being that these unpleasant 
effects have usually followed very small doses, sometimes of 
only a single grain. Urinary irritation is also occasionally 
produced, more especially in the old, and consisting of dys- 
uria, renal congestion, and even hemorrhage. And we must 
remember that idiosyncrasy here plays an important n>/<?, 
and that some persons cannot take a single grain without 
inconvenience. 

Therefore, as before advised, it is always well, before pre- 
scribing quinine, to ask our patient if he has ever taken it 
before. If much prostration follows a large dose, strong 
black coffee with brandy is the best antidote. 

Mode of Administration and Dose. 

This salt is best prescribed in mixtures with a little nitric 
or dilute sulphuric acid, as tinctures do not dissolve it well ; 
though, as Ringer says, it is really unnecessary to combine 
acid, as the quinine is readily soluble in the acid of the gas- 
tric juice. But a little acid makes a more elegant mixture, 
by removing that turbidity which a certain quantity of the 
undissolved alkaloid necessarily imparts to a solution. The 
dose varies from about gr. ij, which is the usual tonic dose, 
to 10, 20, 30 grains, or even more ; and although in this 
country a larger quantity than 10 grains is perhaps rarely 
prescribed, it is clearly absurd to put the maximum dose, as 
in the British Pharmacopoeia, so low as this. 

A good way of obviating the headache and ringing in the 
ears is by adding to each dose tti^xxx of hydrobromic acid, 
which is also a good solvent. 

[As urged by the late Prof. Alonzo Clark, quinine may 
be given by the rectum, in the ordinary form of suppositories, 
with almost if not quite as much efficacy and promptness of 
action as when given by the mouth. When given in the 
usual way it is found that to avoid its bitter taste is abso- 
lutely necessary in some cases. For this purpose it is some- 
times ordered in sugar-coated pills, or inclosed in cachets de 
pain. The powder may be given to children in a spoonful 
of syrup of red orange, or mixed with honey or molasses ; it 



CINCHONA. 



261 



may also be taken in coffee, or simply suspended in cold 
water, or the powder sprinkled over the cut surface of an 
orange. The quinine may be enveloped in tissue paper and 
twisted tightly into a ball ; a little practice will enable an adult 
to deftly swallow such a bolus without tasting, and with but 
little inconvenience. The aromatic elixir of glycyrrhizin has 
been recommended as the best vehicle for the administration 
of the sulphate of quinine ; l but preparations containing lico- 
rice, such as the officinal fluid extract of taraxacum, or the 
compound licorice mixture, or the elixir of Yerba Santa, are 
quite satisfactory for this purpose. Tannin has the power of 
disguising the taste of quinine, and, according to Rolander, it 
does not detract from its therapeutic properties. The fol- 
lowing formulae will be found useful for the administration of 
quinine in solution : — 
For children — 

R. Quininae sulphatis gr. xxiv ; or 1 50 6m. 

Acidi tannici gij ; " 8 " 

Syr. cinnamomi f^iij ; " 96 " M. 
S. Capiat cochleare parvum ter in die. 

Or, as the disulphate — 

]$. Quininse sulphatis gr. xxiv ; or 1 50 Gm. 

Acidi sulphurici dil. f ^j ; " 4 

Tr. cardamoini co. f 3 U J '■> " 12 

Syrupi q. s. adfgiij; " 96 " M. 

S. Dose, f 3j. 

Or, in a cough mixture — 

]£. Quininse sulphatis gr. xxiv ; or 1 50 Gi 

Acidi sulphurici dil. q. 
Mist, glycyrrhizse co. 
S. Dose, teaspoonful. 

In the declining stage of whooping-cough. 

For adults, any of the preceding prescriptions may be 
used, or we may give the following : — 



gr. xxiv ; 


or 


1 


ad solve ; 






adf^iij; 


a 


96 



fy. Quinine sulphatis gr. xlviij ; or 3 
Acidi sulphurici dil. q. s. ; 

Syrupi liinonis f§ij ; " 64 

Aquse q. s. ad f|vj ; " 192 



20 Gin. 



1 [Remington, Med. and Surg. Rep., vol. xxxvii. p. 88, Phila., 
1877.] 



262 



CINCHONA. 



each drachm containing one grain of quinine. A more plea- 
sant preparation would probably be obtained by substituting 
Curacoa cordial for the lemon syrup. As a tonic carmina- 
tive the following proves very acceptable in weakened 
digestion : — 

]$l. Quininse sulphatis gr. xlviij ; or 3 20 Gi 

Acidi sulphurici dil. q. s. ad solve ; 
Tr. gentianse comp. f^iv; " 

Syr. zingiberis q. s. ad f §vj ; " 

S. Capiat cochleare magnum ante cibutu. 

Wine of- aloes may be appropriately added, should consti- 
pation be present in the case.] 

50 Gra. 

2 

16 

32 

256 



128 
192 



M. 



R. Quininse sulphatis 

Acidi nitrici diluti f 3 SS '■> 

Tincturae aurantii f §ss ; 

Syrupi aurantii cort. f ^j ; 

Aquse q. s. ad i'§viij 

S. Dose, f§j ter die sumendus. 



gr. vnj ; or 



M. 



For a case of debility and want of appetite. 



R- 


Quininse sulphatis 


gr. j ; or 


06 Gm. 




Ferri et potassii tartratis 


gr. ij ; u 


13 " 




Morphinae acetatis 


err 1 ■ " 

gr. X2 » 


005 " M. 


Ft. 


pil. 







A useful combination in neuralgia. 

Some persons, who object to sweets, prefer the syrup to 
be left out; but it will usually be found an agreeable addi- 
tion. Quinine may also be given in the form of simple 
powder, suspended in a glass of sherry, and when a large 
dose, such as 10 grs., is prescribed, it is more conveniently 
taken in simple suspension in distilled water. A very com- 
mon plan is to order quinine with acid infusion of roses, but 
Squire has pointed out that a turbid and unsightly mixture 
is thus produced from the resulting tannate of quinine being 
insoluble in sulphuric acid ; whereas, if the infusion be made 
with nitric acid, the mixture is "bright and attractive in 
appearance." 

Under the name of Warburg's tincture, a secret prepara- 
tion of unusual complexity has recently been made public, 
and has been most highly recommended by Maclean in tropi- 
cal diseases, and by Broadbent and Flay fair in cases of shock 
and collapse. Under its use free perspiration sets in, and 
the temperature goes down, and it is believed that the action of 



CINCHONA. 263 

the drug is materially aided by the powerful aromatics with 
which it is combined and the state of concentration in which 
it is given. Each one-ounce bottle contains 9^- grains of 
quinine, and it is best given on an empty stomach after pre- 
liminary evacuation of the bowels, the ounce being taken 
undiluted and repeated in 2 or 3 hours. 

Other Constituents. 

In addition to quinine other alkaloids and substances have 
been detected in bark, some of which are of use in medicine. 
We have : — 

1. Quinic or kinic acid. 

2. Quino-tannic acid. 

3. Cinchona red. 

4. Kinovin. 

These four have no therapeutic significance. 

5. Cinchonina has some febrifuge power [and sulphate of 
cinchonine can in many cases take the place of quinine as an 
antiperiodic, at about one-eighth the cost]. 

6. Quinidine has been reported as nearly equal to quinine 
in the foregoing respect [and is an efficient substitute for the 
more expensive salt.] 

7. Cinchonidinse sulphas is also officinal and has some 
tonic properties. 

None of these preparations have been able to completely 
take the place of quinine, as they are weaker, less certain in 
action, and less agreeable; and quinine, notwithstanding its 
comparatively high price, still retains its position as our most 
reliable antiperiodic. 

Quinetum [or Hospital Quinine] is the mixed alkaloids 
of bark, and has been found to be very efficacious in chronic 
cases of ague. 

The preparations of cinchona, as we said before, are prin- 
cipally used for their tonic properties ; and there is perhaps 
no more pleasant and effectual medicine of this class than 
the ordinary tincture of bark, whilst the decoction or in- 
fusion is useful as a vehicle for more active drugs. 

[The bimuriate of quinine with urea, quininaa bimuriaticum 
carbamidatum, is a very soluble form of double salt lately in- 
troduced, which has especial advantages for the hypoder- 
mic method in treating severe forms of ague. 

The relative therapeutic activity of the ordinary alka- 



264 CINCHONA. 

loids as compared with each other is thus given by 
Bartholow : — 

Quinidine is entitled to the first rank as an antiperiodic. 

Quinine (usually given in doses that are too small). 

Cinchonine is about one-half the strength of quinine. 

Cinchonidine is a little stronger than cinchonine. 

Quinoidine, or chiniodine (amorphous), is about one-fourth 
the strength of quinine. 

The salicylates of quinine and cinchonidine have been in- 
troduced, and are especially recommended for neuralgia."] 

[Chinolin. — The tartrate and salicylate of chinolin 
have been introduced as substitutes for the cinchona alka- 
loids, attention having been directed to them, under the 
name of artificial quinine. 

The ordinary commercial chinolin is a reddish-brown 
liquid, while the tartrate is a white crystalline powder. It 
often has a disgusting tobacco-like odor, due to some uncom- 
bined chinolin or to slow decomposition. Rueber 1 found 
that by repeated distillations of chinolin made synthetically 
according to Skraup's method (48 parts nitro-benzole, 76 
parts aniline, 240 parts of glycerine, and 200 of English sul- 
phuric acid), he obtained a colorless, transparent, oily liquid 
which remained unchanged after six months, from which a 
specimen of fine acicular crystals of chinolin tartrate was 
obtained, which possessed only a faint odor. The salt was 
insoluble in ether, soluble in 65 parts of alcohol and in 20 
parts of water at 15° C. ; but water at 100° dissolves six 
times as great a proportion ; the excess afterwards deposits 
on cooling. The author confirms the experience of Dr. 
Donath as to the value of this salt as an antiseptic, and 
asserts that it possesses no properties which would render it 
deleterious to health when used for the preservation of arti- 
cles of food. 

The tartrate of chinolin is said to have decided effect in 
periodical neuralgia and in intermittent fever, in doses of 
one or two grammes to adults, given in waters or cachets de 
pain; it may be given to children in equal parts of syrup 
and distilled water. Peppermint is recommended as a vehicle 
for disguising the taste. It is said not to produce tinnitus 
or other cerebral disorder. In malaria, it has proved efficient 

1 [Monthly Review of Medicine and Pharmacy, translated from 
Schweizerische Wochenschrift, No. 49.] 



CINNAMON. 265 

in some cases, but requires to be given in doses larger than 
quinine. 

The physiological action of the tartrate of chinolin may 
be summed up as that of a decided apyretic and powerful 
antizymotic. Dr. Donath declares that it is superior in its 
antiseptic power to salicylic, boric, and carbolic acids, or to 
copper sulphate and alcohol. In the proportion of 0.2 per 
cent, it arrests fermentation in milk and the development of 
bacteria; a 0.4 per cent, solution will prevent decomposition 
of blood or the curdling of milk. When administered inter- 
nally, it has not been found in the urine, and appears to be 
decomposed in the system. As a local antiseptic, it has spe- 
cial advantages.] 



CINNAMOMUM— CINNAMON. 

[ The inner bark of the shoots of Cinnamomum Zeylanicum, Breyn (Ceylon 
Cinnamon), or the bark of the shoots of one or more undetermined spe- 
cies of Cinnamomum, grown in China (Chinese Cinnamon) (N. 0. 
Lauraceoz). 

Oleum Cinnamomi. Dose, gtt. j-ij (.06 to .12 Gm.). 

Officinal Preparations, U. S. 

Tinetura Cinnamomi (3jss to Oj). Dose, f3j-ij 4. 
to 8. Gm.). 

Aqua Cinnamomi. As a vehicle. Dose indefinite. 

Pulvis Aromatieus (see Cardamom). Dose, gr. x- 
xx (.60 to 1.30 Gm.). 

Spiritus Cinnamomi (oil, 10 per cent.). Dose, f3j-ij 
(4. to 8. Gm.). 

Also enters into Acidum Sulphuricum Aromaticum, Tine- 
tura Catechu Composita, Tinetura Lavandulae Composita, 
Syrupus Rhei, Tinetura Rhei Aromatica, Syrupus Rhei 
Aromatieus, Tinetura Cardamomi Composita, Tinetura 
Catechu Composita, and Vinum Opii.] 

Cinnamon is principally used for flavoring purposes, but 
also seems to have slight astringent properties, which make 
it useful in diarrhoea. [It has been also strongly recom- 
mended in uterine hemorrhage, given in substance, or as a 
decoction made with milk.l 
23 



266 COCHINEAL — COLCHICUM. 

[COCCUS— COCHINEAL. 

The dried female of Coccus cacti, Linne* (Class Insecta; Order 
ffemiptera). 

It enters into Tinctura Cardamomi Composita. 

Cochineal has been considered to possess antispasmodic 
and anodyne properties, and has been recommended in 
whooping-covgh (gr. ^, s. t. d., to infants) combined with 
carbonate of potassium. It is also used in neuralgia. In 
pharmacy it is used as a coloring agent. J 



[CODE1NA— CODEINE. 

An alkaloid prepared from Opium. 

See Opium.] 



COLCIIICI RADIX— COLCHICUM ROOT. 

[ The corm of Colchicum autumnale, Linne (iV. 0. Melanthaceoz) .] 

COLCHICI SEMEN— COLCHICUM SEEDS. 

[The seed of Colchicum autumnale, Linne (N. 0. Melanthaceoz) . 
Dose, of either, gr. ij-v (.13 to .32 Gm.). 

Officinal Preparations, U. S. 

Extraetum Colehiei Radicis. Dose, gr. j-ij (.06 
to .12 Gm.). 

Extraetum Colehiei Radieis Fluidum. Dose, 

n^ij-iv (.12 to .24 Gm.). 

Vinum Colehiei Radieis (40 parts; stronger white 
wine q. s. to make 100). Dose, gtt. x-xv (.60 to 1. Gm.). 
As a purgative, n^xxx (2. Gm.). 

Extraetum Colehiei Seminis Fluidum. Dose, 
Trui-vj (.12 to .40 Gm.). 

Tinctura Colehiei (seeds, 15 parts; dilute alcohol 
q. s. to make 100). Dose, n^v to f'3j (.30 to 4. Gm.). 

Vinum Colehiei Seminis (seeds, 15 parts; stronger 
white wine q. s. to make 100). Dose, ni^x to 3j (-65 to 4. 
Gm.).] 



COLCHICUM. 



267 



Internal Action. 



Physiological. 

The leading physiological 
action of colchicum is un- 
doubtedly directed to the in- 
testinal canal, large doses 
causing free vomiting and 
copious purging of yellowish 
feces containing a large quan- 
tity of bile. The action of 
the heart is usually somewhat 
depressed. 

Christison, Maclagan, and 
others assert that the propor- 
tions of urea and uric acid, as 
well as the amount of urine 
excreted, are increased, but 
this is denied by Gubler. 

Gubler denies all specific 
action, believing it to be a 
spoliative ; and only exerting 
its full powers when physio- 
logical effects are produced, 
from three to four stools a 
day being recommended. He 
believes it to be "cumula- 
tive." 



Therapeutical. 

As the experiments of 
Rutherford have shown that 
colchicum increases the bil- 
iary secretion, it may be a 
useful adjunct to cholagogue 
pills, although its own purga- 
tive action is too violent to 
be encouraged. 

Its principal use is as a 
remedy for gout, more espe- 
cially the acuter forms, and 
here it never fails to remove 
pain rapidly, without, how- 
ever, in any way lessening 
the tendency to future at- 
tacks. How it acts is un- 
known, and we can only call 
it a specific. It is also very 
valuable in various diseases 
of gouty parentage, as in some 
forms of dyspepsia, bron- 
chitis, etc.; but in acute 
rheumatism it has been proved 
to exert rather a noxious than 
a beneficial influence. 



Dose and Mode of Administration. 

Colchicum may be given either in one or two full doses, 
or in smaller quantities spread over a longer time. Of these 
plans the former is probably the more effectual in an acute 
attack of gout. Alcohol is said to be the best solvent, be- 
cause all acids, even those of urine and vinegar, transform 
the colchicine into colchiceine, a neutral glucoside of very 
inferior strength. The following formulae are suitable for 
various gouty conditions : — 



$. Tincturae colchici v\xx 

Potassii bicarbonatis gr. x 

Aquae pimentae [Br.] f§j ; 

Misce, fiat haustus ter die sumendus. 



32 



30 Gm. 



268 



COLCHICUM. 



Tincturae eolchici ~n\xv ; 

Magnesii earbonatis gr. vj ; 

Magnesii sulphatis gr. xxx 

Aquae inenthae piperitse q. s. ad f%] ; 
Pro dosa, ter die sumendus. 



$• 



S. 



S. Capiat unciam bis in die. 

$. Extracti eolchici radicis gr. x 

Pulveris digitalis, 
Extracti colocynthidis conip., aa £)j 



Ammonii earbonatis 




gr. xl 


Sodii bicarbonatis 




3 iss ; 


Tincturae eolchici 




f 3*j ; 


Syrupi aurantii 




f 3iv ; 


Aquae 


q. s. 


ad f §viij 



16 

256 



Gra. 



40 



60 Gm. 



M. 



M.] 



Misce, fiant pilulse xx. 

I£. Potassii iodidi, 

Ammonii earbonatis, 
Vini eolchici 
Tincturae scillae, 
Tincturae hyoscyami, 
Aquae camphorae 

S. f §ss ter die. 



Sumat unam bis terve in di 



aa 9j ; or 1 



aa f 5jij ; 

q. s. ad f §iij 



65 Gm. 
30 " 



30 Gm. 



M. 



Dr. Greenhow's formula for gouty bronchitis. 



[Scudamore's mixture 
B,. 



Magnesii sulphatis 
Magnesiae 

Aceti eolchici [Br.] 
Syrupi croci [Br.] 
Aquae menthse pip. 
Dose, t'3ss-iss repeated every 



5J- 

3i.i 



u ; 

gr. 

-iss 



32 
10 
32 
32 
320 



Gm, 



60 



M. 



2 hours in a paroxysm of gout 



until from four to six evacuations are produced in the 24 hours.] 

[The acetum eolchici was omitted from the Pharmacopoeia 
in the last revision. It was made from the corm, and was 
only one-third the strengtli of the officinal wine of colchicum 
root. In making preparations the fresh seed should be used, 
as the old seed and its preparations are less active ; some 
samples of fluid extract contain no colchicine at all.] The 
active principle colchicine is from 80 to 100 times more 
powerful than the plant, and has been used hypodermically 
in chronic rheumatism and gout. Dose, gr. ^ (.002 Gm.). 



COLLODION. 



269 



[COLLODIUM—COLLODION. 

Pyroxylon 4 parts, dissolved in stronger ether 70 parts, and alcohol 26 
parts, cantharides 60 parts, flexible collodion 85, commercial chloroform 
q. s. to make 100 parts, 

Collodium cum Cantharide. Blistering Collodion. 
Collodium Flexile. Flexible Collodion. (Collodion 
92. Canada turpentine 5, castor oil 3.) 

Collodium Styptieum. (See Tannic Acid.)] 



Collodion is used to fulfil 
two indications: — 

1. To exclude the action 
of the air from inflamed parts, 
and to prevent the patient 
from scratching; and irritating 
the surface. 

2. To exert a moderately 
constringent effect, from the 
contraction which follows its 
drying, and the gentle com- 
pression which can thus be 
exerted may be of great ser- 
vice in checking inflammatory 
conditions. Mr. Gamgee 
praises its use highly in 
orchitis, where it should be 
freely painted over the tes- 
ticle and cord. 



1. For this purpose it is 
used to paint over the pus- 
tules of smallpox, in the hope 
of preventing pitting. Also, 
in herpes zoster and in ery- 
sipelas it may be applied 
with advantage. 

2. Dr. Hale tells us that, 
at the very early or papular 
stage of a boil, we may avert 
subsequent suppuration by 
the application of collodion. 
[In the early stage of a boil 
it may sometimes be aborted 
by touching the top with a 
drop of cantharidal collo- 
dion.] 

Sir D. Corrigan recom- 
mends sealing up the ex- 
tremity of the prepuce by 
collodion to remedy the 
nocturnal form of inconti- 
nence of urine in children ; 
and it may be of service in 
hemorrhage depending on 
capillary oozing, and more 
especially in the troublesome 
bleeding frequently following 
leech-bites. 

Finally, its application 

may facilitate the healing 

process in small cuts and 

wounds, as after the operation 

23* 



270 COLOCYNTH. 

of harelip, and in the trouble- 
some condition known as 
cracked nipples. Under all 
these conditions the best re- 
sults may be obtained by- 
using the flexible collodion, in 
which the combination with 
castor-oil prevents the too 
rapid cracking or peeling 
away of the protecting film. 

Under the name of styptic colloid, Dr. Richardson has 
introduced an efficient remedy for checking capillary oozing 
and promoting the healing of slight wounds. It is thus 
composed : Collodion 100 parts ; carbolic acid 10 parts ; 
tannin 5 parts ; benzoic acid 5 parts. 

Collodium flexile is made with Canada balsam and castor- 
oil, and collodium vesicans [Br.] is now an official preparation. 

Flexible collodion and chrysophanic acid form a good com- 
bination, and Mr. Carteighe tells me that flexible collodion 
with salicylic acid and extract of Indian hemp is an excel- 
lent application to soft corns. 



COLOCYNTHIS—COLOCYNTH. 

[ The fruit of CitruUus Colocynthis deprived of its rind, Schrader 
(N. 0. Cucurbitacece) . 

Officinal Preparations, U. S. 

Extractum Colocynthidis (alcoholic). Used only 
in combination. Dose, gr. ij-v (.12 to .30 Gm.). 

Extractum Colocynthidis Compositum (aloes 
100, ext. colocynth 32, resin of scammony 28, cardamom 
12, and soap 28 parts). Dose, gr. v-xxx (.30 to .2 Gm.). 

Pilulae Cathartic® Compositae. See page 216. 

Physiological Action. Therapeutical Action. 

Colocynth produces a good Bitter cucumber is a dras- 

deal of irritation of the large tic purgative, rapid and effi- 

intestine, causing profuse cient in its action, and much 

watery evacuations, and, if used as an ordinary remedy 

given in excessive dose, even in habitual constipation and 

proving fatal by inflammation various dyspeptic conditions. 



HEMLOCK. 271 

and ulceration. It is found, In large doses it is a pow- 

however, that its drastic ac- erful hepatic as well as intes- 

tion, as well as the griping to tinal stimulant. It renders 

which it occasionally gives the bile more watery, but in- 

rise, may be obviated by creases the secretion of bil- 

combination with aromatics iary matter, 
and other purgatives. 

Mode of Administration. 

Colocynth is rarely, if ever, prescribed alone. The offi- 
cinal compound extract and pill, containing, in addition, aloes 
and scammony, are useful formulae ; but the best mode of 
combination is undoubtedly that with either hyoscyamus or 
belladonna, the dose being from 5 to 10 grains. 



[Confectiones. 

The officinal Confections are : — 

Coufectio Rosae (Red Rose 8, Sugar 64, Clarified honey 12, Rose 
water 16). 

Confectio Sennae (Senna 10, Coriander 6, Cassia Fistula 16, Tama- 
rind 10, Prune 7, Fig 12, Sugar 50, Water 60, to make 100 
parts). Dose 5j-3ij (4-.89 Gin.).] 



CONIUM— HEMLOCK. 

The full-grown fruit of Conium maculatum, Linne (N. O. Umbelli- 
ferce, Campylospermaz) , gathered while yet green. 

Dose, grs. ij-v (.13-30 Gm.). 

Officinal Preparations, U. S. 

Extractum Conii Fluidum. Dose, ny-v (.06 to 
.30 Gm.). Seguin says that much larger doses are often 
well borne. 

Abstraetum Conii. Dose, gr. j-iv (.06 to .25 Gm.). 

Extractum Conii Alcoholicum. Dose, gr. ^-ij 
(.03 to .12 Gm.). 

Tinetura Conii (15 per cent.). Dose, f3ss-j (2. to 4. 
Gm.). 



212 



HEMLOCK. 



Test Conine, a liquid alkaloid, the active principle of 

conium, is volatile, and exhales a strong mouse-like or uri- 
nous odor. With the vapor of hydrochloric acid, it forms 
dense white fumes. The odor of conine is so characteristic, 
that it can scarcely be confounded with any other poisonous 



Antidotes. 
Atropine has been suggested as a physiological antidote.] 

Local Action. 

Conium has been occasionally used in the form of poultice 
as an application to cancerous sores or tumors, and it is said 
that the severe lancinating pain common to these affections 



may thus be mitigated. 



Internal Action. 



Physiological. 

I. On Nervous System 

No effect is pro- 
proper, 



1. Brain. 

duced on the brain 
it having been observed in 
cases of poisoning, and nota- 
bly in that of Socrates, and 
in a patient under Prof. Ben- 
nett's care, that the intellect- 
ual faculties are quite unim- 
paired to the last. 

Dr. John Harley, however, 
is of opinion that a consider- 
able portion of the action of 
conium is expended on the 
motor ganglia, and more es- 
pecially the corpus striatum. 

2. Spinal Cord Pure 

conium has no special influ- 
ence on the spinal nervous 
system, but an alkaloid, met- 
hyl-conine, which it usually 
contains, has been proved to 
cause first exaltation, and 



Therapeutical, 



I. To this action Dr. Har- 
ley ascribes the beneficial in- 
fluence of conium in chorea. 
Although in many cases we 
may derive real advantage 
from this remedy, it often 
fails, and in order to insure 
the full amount of benefit we 
must use large doses, and see 
that the drug is pure. Dr. 
Harley also recommends it in 
the nervous twitchings met 
with in some cases of hemi- 



HEMLOCK. 



213 



finally depression of the re- 
flex function of the cord. 

3. On the Nerves Herein 

lies the true physiological 
action of conium. It acts 
first on the third nerve, 
causing drooping of the eye- 
lid, dilatation of the pupil, 
and sluggish and impaired 
movement of the eyeball. 
The influence then spreads 
to all the other motor or 
efferent nerves. A sensation 
of weight and enfeeblement 
of the legs, followed by stag- 
gering, is first experienced, 
and finally total paralysis is 
developed, the victim being 
entirely unable to move ; and 
so complete may this become, 
that asses in Italy which have 
fed on hemlock have been 
flayed alive without the pos- 
sibility of resisting in any 
way. This paralyzing influ- 
ence is at first confined to 
the terminal extremities of 
the nerves. Conium usually 
contains some methyl-conine, 
which considerably modifies 
the action of the pure alka- 
loid. This substance does 
not, like conine, expend its 
action on the end organs of 
the motor nerves, but extends 
to the cord, first exalting and 
finally abolishing its reflex 
function. 

The sensory nerves are 
quite unaffected. 

II. Vascular System. — 



plegia. Conium has been 
given with some benefit in 
the convulsions of children. 

3. Dr. Harley recom- 
mends its use in the violent 
spasm of the orbicularis met 
with in keratitis, but I have 
been unable to confirm this 
after careful trial. 

The remarkable power of 
conium in affecting muscular 
relaxation would indicate its 
use in a variety of spasmodic 
conditions. Thus, in laryn- 
gismus stridulus, trismus, 
spasmodic wry neck, spas- 
modic stricture [hysteria, 
and insanity'], and perhaps 
in the reduction of hernia 
and dislocation where any 
contra-indication to the use 
of anaesthetics exists, it seems 
worthy of trial; and Dr. 
Handfield Jones recommends 
it highly in paralysis agi- 
tans. It must, however, be 
confessed that the therapeu- 
tical success of conium by no 
means comes up to its physi- 
ological promise. [Dr. Seguin, 
of New York, explains its 
failure by the smallness of 
the quantity usually ordered. 
In chronic convulsive dis- 
orders he gives as much as 
a drachm at a dose and never 
less than twenty minims for 
adults. In the latter amount 
he gives it as an indirect 
hypnotic, in combination 
with bromide of potassium. 



2*74 HEMLOCK. 

No effect is produced on the From these truly extraordi- 

heart or circulation. nary doses of the fluid extract 

III. Respiration and Tern- he claims never to have had 
perature — The breathing is any serious or threatening 
at first unaffected, but, as the symptoms produced.] 
poisonous action of the drug Dr. Crichton Brown has 
goes on, the paralysis spreads seen good results from the 
to the respiratory centre, and use of conium in mania with 
death ensues from asphyxia, violent motor excitment, in 

Some lowering of the tern- which it restrains the violent 

perature has been observed. muscular movements ; and 

IV. Secretion. — No influ- Dr. R. Burman has used 
ence on secretion has been conine by subcutaneous in- 
noted, jection successfully in the 

same class of cases. 

Mode of Elimination. 

The presence of conium has been detected in the blood, 
and its elimination is effected by the breath and urine. 

Mode of Administration, Cautions, etc. 

It having been satisfactorily proved that the succus is the 
most active preparation of hemlock, it is not necessary for 
us to say anything about the tincture, extract, vapor, or com- 
pound pill. Unfortunately, however, it is often difficult to 
obtain an efficient succus, as it keeps ill, and cannot always 
be satisfactorily made, the cultivated plant, which is some- 
times used, being quite inert. Disappointment frequently 
occurs both from this cause and from the smallness of the 
dose often given in accordance with the recommendation of 
the Pharmacopoeia. In order to obtain any decisive effect 
we must give, of some preparations, as much as from half an 
ounce to 3 or even 4 ounces, as has been done by Dr. Har- 
ley, remembering that the limit of safety is reached when any 
interference with involuntary movement is observed, this 
being best indicated by enfeeblement of deglutition. 

Children bear conium-juice remarkably well. I have given 
ounce doses to a girl of eight, and the late Dr. Anstie gave 
to a girl of seven, suffering with chorea, o v "j i n 24 hours, 
without the slightest development of physiological symptoms. 
[On account of the uncertainty of the strength of juice, it is 
best to begin with small doses, and carefully increase them 



COPAIBA. 275 

until some paralytic effect is produced. Death has been 
caused by 150 minims of Squibb's fluid extract. Attention 
has been called by Dr. Squibb to the danger of diluting the 
fluid extract, for a precipitate may be formed containing the 
active principle, and by this means a poisonous dose may 
finally be given. He had seen serious symptoms but never 

fatal accident from this cause Trans. Med. Soc. State of 

New York, 1882.] 

Hypodermic Use. 

The alkaloid conine has been occasionally used by sub- 
cutaneous injection, but is objectionable from being very 
variable in strength. When injected pure it is not only 
physiologically inert, but is very irritating, and the addition 
of acetic or hydrochloric acid is necessary to insure physio- 
logical action. When taken by the mouth it is rapidly and 
certainly poisonous, from 10 to 15 minims having proved 
fatal. 

fy . Coninse 5iij, TTjxij ; or 12 80 Gm. 

Acid, acetici fort. f 5ijss ; " 10 " 

Alcoholis f3j; "4 " 

Aquse destillat. q. s. ad Jfiij ; " 96, " M. 

Seven and a half minims of this solutiou contain one minim of 



COPAIBA—COPAIBA. 

[ The oleo-resin of Copaifera, Langsdorffii, Desfontaines, and of other 
species of Copaifera (N. 0. Leguminosce, Papilionacece). 

Dose, flixv to 3j (1 to 4 Gm.). 

Officinal Preparations, U. S. 

Massa Copaiba? (Copaiba 94, magnesia 6). Dose, 
gr. x-xxx (.65 to 2 Gm.). 

Oleum Copaiba?. Dose n^viij-xv (.50 to 1 Gm.). 
Resina Copaiba?. Dose, n^viij-xv (.50 to 1 Gm.).] 

Local Action. 

Physiological. Therapeutical. 

Copaiba locally applied It has been used in this 
seems to act as a slight way in certain obstinate af- 
stimulant to the skin. fections of the skin, such as 



276 



COPAIBA. 



psoriasis ; and in India it 
seems to have been employed 
with some success in leprosy 
and lupus, bearing as it does 
a considerably analogy to the 
gurjun oil which has lately 
acquired so high a reputation 
in the treatment of the first- 
mentioned disease. Its nau- 
seous smell, however, must 
always be a serious barrier to 
its use. 



Constitutional Actions. 



1. Brain and Nervous 
System. — No influence is ex- 
erted by copaiba on the brain, 
spinal cord or nerves. 

II. Heart and Circula- 
tion. — No effect is produced 
on these organs, or on the 
respiration and temperature. 

III. Digestive and Secret- 
ing Organs. — 1. Stomach 
and Intestines Copaiba fre- 
quently causes most violent 
vomiting and purging. 

2. It has a stimulating ef- 
fect on mucous membranes 
generally, but more espe- 
cially on those of the genito- 
urinary tract, in virtue of 
which, after slight prelimi- 
nary irritation, it checks and 
finally arrests excessive dis- 
charges. 

3. Kidneys. — Copaiba, and 
more particularly the resin, 
increase very considerably 
the water of the urine with- 
out specially affecting the 
solid constituents. 



Copaiba is an excellent 
remedy (1) in gonorrhoea, 
where it may be given with 
great effect as long as the 
discharge continues thick 
and puriform. When the 
earliest inflammatory symp- 
toms have been subdued by 
alkalies and diluents, it will 
prove our best remedy, and 
it seems to act neither purely 
locally nor constitutionally, 
but in both ways conjointly, 
being altered in some way in 
the blood, and then exerting 



COPAIBA. 217 

4. Copaiba, by internal a topical influence on the 

administration, seems to stim- affected mucous tract. (2) 

ulate the skin, and occasion- It is also of service in chronic 

ally produces an eruption of cystitis, and in the later stages 

bright red papules, not un- of bronchitis, when profuse 

like measles, usually begin- and exhausting discharges 

ning on the hands, spreading have been established from 

over the body, and causing the bronchial tubes. (3) 

much tingling and itching. As a diuretic, the resin has 



been most highly praised by 
Dr. Wilks and Dr. F. Taylor 
in the dropsy of heart disease, 
in ascites, and in some forms 
of renal affections. (4) Dr. 
Liveing, more especially, has 
drawn attention to the value 
of copaiba in psoriasis and 
other obstinate skin diseases. 

Absorption and Mode of Elimination. 

Copaiba is very rapidly absorbed into the blood, as indi- 
cated by the communication of its nauseous smell to the 
breath and urine, by which channels it is principally elimi- 
nated. On the addition of nitric acid to the urine of patients 
taking copaiba, a milky appearance is produced by precipi- 
tation of the resin, and this is distinguished from albumen 
by the action of heat, which melts the resin and removes the 
deceptive cloud. 

Peculiarities. Mode op Administration. 

The digestive disturbance occasionally caused by copaiba 
prevents some persons from taking it at all, and the almost 
invincibly nauseous nature of its flavor and odor is a serious 
drawback to its use. Capsules both of sugar and gelatine 
have been devised, which are frequently well borne ; but w r e 
must remember not only that these are often too large to be 
swallowed with comfort by nervous persons, but that their 
use is apt to be followed by disagreeable eructation. No 
means have been proposed to obviate the measly and irritable 
rash which not unfrequently appears on the skin of patients 
under the influence of copaiba ; but various forms of pre- 
scriptions are in general use, and some of these are mode- 
24 



278 



CORIANDER. 



rately effectual in concealing the offensive flavor of this use- 
ful drug. 



I£. Copaibse, 

Liquoris potassae, aa f 5ss ; 

Misce, agitando, et adde — 

Mucilaginis acaciae f 5ij ; 

Spiritns aetheris nitrosi f gss ; 

Tincturae opii TT^v ; 

Aquse q. s. ad f % j ; 

Fiat haustus ter die sumendus. 

For gonorrhoea. 

I$l. Copaibae, 

Syrupi tolutani, 

Pulveris acaciae, aa f§ss ; 

Acidi sulphurici aromat. f J^ss ; 
Aquse destillatae f ^vj ; 

S. f j§ss ter in die. 

For gonorrhoea. 

I£. Resina copaibas giij ; 

Alcoholis f 5v 5 

Chloroformi f 31 ; 

Mucilaginis acacias f.^ij ; 

Aquae q. s. ad f |xij : 

S. Capiat semunciam ter in die. 

Formula for copaiba as a diuretic. 



32 



16 

2 

192 



12 

20 

4 

64 
384 



Gm. 



30 



Gm. 



Gm. 



M. 



M, 



M. 



[CORIANDRUM— CORIANDER. 

The fruit of Coriandrum Sativum, Linn4 (N. 0. Umbelliferce, Coelo- 
spermoz). 

Dose, gr. xx (1.30 Gm.). 

Oleum Coriandri. Dose, n^j-v (.06 to .30 Gm.). 
Enters into Confectio Sennae. 



Uses. 

Coriander seed is aromatic and stomachic ; it is rarely 
used except in combination.] 



CORNUS — PREPARED CHALK. 2T9 

[CORNUS— CORNUS (DOGWOOD). 

The bark of the root of Cornus Florida, Linnd (N. 0. Cornacece). 

Officinal Preparation, U. S. 

Extraetum Cornus Fluidum. Dose, f5ss (2. 
Gra.). 

Dogwood is an indigenous, astringent tonic, and has been 
recommended as an antiperiodic as a substitute for cinchona.] 



CREASOTUM— CREASOTE. 

[A product of the distillation of ivood-tar. 

Officinal Preparation, U. S. 

Aqua Creasoti (one per cent.). Dose, f 3ss-iv (2. to 
16. Gm.).] 

This drug [dose, gtt. i-x (.06 to .65 Gm.), diluted] is now 
but little used [owing to the difficulty of obtaining it pure, 
the commercial article being largely contaminated with cre- 
sylic or carbolic acid] ; but it is a useful remedy in some forms 
of sickness and vomiting, as an inhalation for ozcena and 
various lung diseases with fetid expectoration, and as a 
local application in toothache. 

[Beech wood creasote has been used in the treatment of 
phthisis with excellent results by Beverley Robinson and 
others. Dose, gtt. iij-xv after meals. It may be given with 
compound tincture of gentian and whisky. A mixture of 
equal parts of creasote, alcohol and spirits of chloroform is 
used with the inhaler, with good effect. 1 ] 

The mistura creasoti [Br.], containing n\J to the ounce, 
is a convenient mode of administration. [The ointment 
(3 ss -3j) is sometimes used in scaly erwptions.~\ 



[CRETA PRtEPARATA—PREPARED CHALK. 

Native friable carbonate of calcium (CaCo 3 -100), freed from most of 
its impurities by elutriation. 

(For Preparations, see Calcium.)] 

[* Dr. Austin Flint, Jr., N. Y. Med. Jour. Dec. 8, 1888.] 



280 SAFFRON — CUBEB. 

CROCUS— SAFFRON. 

[ The stigmas of Crocus sativus, Linne" (N. 0. Iridacece). 

Officinal Preparation, U. S. 

Tinetura Croei (10 per cent.). Dose, f 5j-ij (4 to 8 
Gm.).] 

Saffron is never used, save as a coloring agent. [Saffron- 
tea is sometimes used in domestic practice and by irregulars 
as a diuretic, and for infantile jaundice. It probably has no 
advantage over warm water.] 



CUBEBA— CUBEB. 

[The unripe fruit of Cubeba officinalis, Miquel (N. 0. Piperaceoz). 
Dose of the powder, gr. xx to 3U (1.60 to 8. Gm.). 

Officinal Preparations, U. S. 

Extractum Cubebffi Fluidum. Dose, n^x^ss 
(.05 to 2 Gm.). 

Oleo-Resina Cubebffi (8 times the strength of the 
powder). Dose, n^x-xxx (.60 to 2. Gm.). 

Oleum Cubeba^. Dose, r^v-xij (.30 to .80 Gm.). 

Tinetura Cubeba^ (10 per cent.). Dose, f'3ss— ij (2. 
to 8. Gm.). 

Trochisei Cubeba^ (each contains gr. \ of the oleo- 
resin). Dose 1 to 5.J 

Physiological Action. Therapeutical Action. 

Cubebs also has a stimu- Cubebs is occasionally used 
lating action on mucous mem- in cystitis, but it has long 
branes, and more particularly been known as one of the 
on that of the bladder and most efficient and generally 
urethra. In large doses it prescribed remedies for gon- 
causes considerable gastro- orrhcea, acting best during 
intestinal irritation. the acute stage of the disease. 

It has also been found use- 
ful when given in the form 
of lozenges for the relief of 
relaxed sore-throat. 



COPPER. 281 

[The following prescription was employed at Prof. Jos. 
Pancoast's clinic : — 



I£. Aluminis 5j 5 or 4 

Cubebse, 5vii J M 28 

Myristicae, 
Cinnamomi, aa 5ij I " 8 

Fiat pulvis et divide in chartse No. xx. 



Gm. 



" M. 

One to be given several times a day in gonorrhoea.'] 



CUPRUM—COPPER. 

[Cupri Aeetas. Acetate of copper (Cu(C 2 H 3 2 ) 2 H 2 
0-199.2). 

Cupri Sulphas. Sulphate of copper (CuSo 4 ,5H 2 0- 
249.2). 

As an emetic, sulphate of copper is given in doses of gr. 
ij-v (.12 to .30 Gm.). 

Poisoning. 

The salts of copper in large doses cause vomiting, pain in 
the bowels, cramps in the lower extremities, a strong cop- 
pery taste, diarrhoea, convulsions, palsy, insensibility, and 
death. Marks of inflammation in the stomach and intestines 
are often noticed after death. When the case has been pro- 
tracted, there is often a green tinge of the lining membrane, 
and a jaundiced appearance of the skin. 

Tests. 

The sulphate in a solid state presents a bright blue color, 
and leaves an astringent metallic impression on the tongue. 
When in solution the transmission of sulphuretted hydrogen 
affords a brownish-black (sulphuret of copper) precipitate. 
Solution of ammonia precipitates a blue substance, which, on 
further addition of ammonia, becomes dissolved; but when 
only a small amount of the poison is present, no precipitation 
occurs, a clear violet-colored solution being then at once pre- 
sented. Ferrocyanide of potassium throws down a reddish- 
brown (ferrocyanide of copper) precipitate. A piece of pol- 
ished zinc or iron (as the blade of a table-knife) acquires a 
plating of copper, if placed in a liquid containing the above 
salt. 

24* 



282 



COPPER 



The tests for the acetate are the same as the preceding, 
except the last. 

The ammonio-sulphate has a brilliant violet-blue color 
and ammoniacal odor. Solution of arsenious acid produces a 
fresh apple-green precipitate. 



Antidotes. 

Albumen, ferrocyanide of potassium, followed by prompt 
evacuation of the stomach. Vomiting should be promoted by 
copious draughts of warm water, milk, or mucilaginous fluids. 
Sugar was formerly recommended. Albumen and milk form 
an insoluble compound with copper, provided they are in 
large excess. The protosulphuret of iron, and iron filings, 
have also been employed with advantage ; but their action 
is too slow. The hydrated oxide of iron has been success- 
fully administered where the arsenite of copper has been 
taken.] 

Local Actions. 



Physiological. 

Copper has caustic astrin- 
gent properties both in sub- 
stance and solution. 



Therapeutical. 

In the form of the familiar 
blue-stone, or sulphate of cop- 
per, it is used as an applica- 
tion to venereal sores, ulcers 
in the throat, granular lids, 
to check exuberant granula- 
tions, etc. ; and in solution it 
is a good lotion for various 
ulcerative surfaces, gleet, etc. 



Internal Actions and Uses. 



Physiological. 

1. Brain and Nervous Sys- 
tem Copper probably acts 

in some measure as a nervine 
tonic, but when given in 
larger doses peculiar symp- 
toms set in, not unlike those 
of lead poisoning, and con- 
sisting of headache, neural- 



Therapeutical. 

1. Copper has been used 
in small doses in chorea, 
epilepsy, etc., but with no 
specially marked benefit. [In 
the treatment of chronic mal- 
arial poisoning, copper in the 
form of the sulphate is some- 
times added to quinine and 



CYDONIUM. 283 

gic pains, cramp, and even piperine, and administered in 

paralysis. the form of a pill with exeel- 

2. Circulation and Respi- lent results.] 
ration No special effect. 

3. Secreting Organs. — 3. Copper is not so much 
Copper causes prompt and used, however, for an emetic, 
effectual evacuation of the as sulphate of zinc, because, 
contents of the stomach, act- if by any chance it be not 
ing as a direct emetic. It has rejected by vomiting, it is 
an astringent influence over liable to cause inflammation 
the stomach and intestines, of the stomach. 

and this, if pushed too far, Sulphate of copper is a 
may end in gastro-enteritis. good astringent in advanced 

and obstinate diarrhoea. 

Mode of Elimination. 

Copper is eliminated chiefly by the liver and kidneys, the 
intestinal canal, and the salivary glands. 

Method of Administration. 

Sulphate of copper is the only salt of the metal used in 
medicine, and may be prescribed as follows : — 

ty.. Cupri sulphatis, 

Pulveris opii, aa gr. ss ; or 103 Grm. 

Extractum gentianae gr. iij ; " |20' " M. 
Misce, fiat pilulse nocte maneque sumenda. 

In a case of obstinate diarrh&a. 

The oleate of copper has recently obtained a considerable 
reputation as an application in ringworm. 



[CYDONIUM— CYDONIUM (QUINCE SEED). 

{The seed of Cydonia Vulgaris, Persoon {N. 0. Rosacece Pomeoz.) 

The only officinal preparation, the mucilage of quince 
seed (Mucilago Cydonii 2 per cent.), is used as a vehicle, 
and as a hair-dressing.] 



284 CYPRIPEDIUM — DIGITALIS. 



[CYPRIPEDIUM—CYPRIPEDIUM (LADIES' 
SLIPPER). 

The rhizome and rootlets of Cypripedium pubescens, Willdenow, and of 
Cypripedium parviflorum, Salisbury (JV. 0. Orchidaceoz) . 

Officinal Preparation. 

Extraetum Cypripedii Fluidum. Dose, n^x-xx 
(.65 to 1.30 Gm.). 

This agent has been popularly employed in the treat- 
ment of nervousness, and nervous functional disorders ; it is 
said to have been used successfully in migraine, hypochon- 
driasis and insomnia. It resembles valerian in its effects 
upon the system, and contains a volatile oil, and a bitter 
principle, with resin and tannic acid. Cypripedin, so-called, 
is a dry alcoholic extract. Dose of the crude drug is about 
15 grains, given several times a day. A tincture and an 
oleo-resin have also been used, the latter in doses of from 
gr. ss-iij.] 



[Decocta. 

An ordinary decoction, the strength of which is not 
directed by the physician nor specified by the Pharmacopoeia, 
shall consist of 10 parts of the coarsely comminuted drug, 
with cold water 100 parts, raised to a boiling point for fifteen 
minutes and strained, and enough water added through the 
strainer to make the product weigh 100 parts. 

The officinal Decoctions are : Decoctum Cetrarise (5 per 
cent.) ; and Decoctum Sarsaparillae Compositum (Sarsapa- 
rilla, 10; Sassafras, Guaiacum wood, Licorice root, aa 2; 
Mezereum, 1 part; Water q. s. to make 100 parts).] 



DIGITALIS—DIGITALIS (FOXGLOVE). 

[ The leaves of Digitalis purpurea, L,inn6 (2V. O. Scrophulariaceoz) , 
gathered from plants of the second year's growth. 

Dose, in substance, gr. ss-ij (.03 to .13 Gm.). 

Officinal Preparations. 

Abstractum Digitalis. Dose, gr. ss-j (.03 to .06 
Gm.). 



DIGITALIS. 285 

Extraetum Digitalis. Dose, \zr.\-\ (.01 to .03 Gm.). 

Extraetum Digitalis Fluidum. Dose, nij-ij (.06 
to .12 Gm.). 

Infusum Digitalis (1.5 per cent.). Dose, f'3j-iv (4. 
to 16. Gm.). 

Tinctura Digitalis (15 percent.). Dose, nr,v-x(.30 
to .60 Gm.). 

Digitalin 1 is no longer officinal.] 

Poisonous Effects. 

Digitalis kills by tetanizing the heart muscle, causing rapid 
and irregular action, followed by arrest of action. The face 
grows pale, the pupils dilate, vomiting and diarrhoea super- 
vene, and death usually occurs by syncope. Cases of poison- 
ing, however, are rare, and most of our knowledge under this 
heading has been derived from experiments on animals. 

Antidotes. 

After evacuation of the stomach and the administration ot 
tannin, we must obviate the tendency to death by stimulants, 
and by keeping the patient rigidly to the horizontal posture, 
as syncope is readily excited by suddenly sitting up. 

Aconite and atropine have been recommended as physio- 
logical antidotes, but we have as yet no evidence of their 
efficacy. 

Local Action. 

Physiological. Therapeutical. 

Digitalis has been said to Digitalis has been used as 
possess sedative properties a local sedative in cases of 
when locally applied, and joint inflammation ; and the 
there is no doubt that it is application to the legs of 
rapidly and efficiently ab- spongio-piline soaked in a 
sorbed by the skin. strong infusion has been found 

to produce diuresis where 
other remedies have failed. 

[ x The investigations of Homolle demonstrated that the sup- 
posed active principle, digitalin, is a mixture of several compounds 
of which digitoxin is crystallizable, and is the most active con- 
stituent.] 



286 



DIGITALIS. 



Constitutional Action. 



I. Brain and Spinal Cord. 
— On the brain no direct ef- 
fect is produced, but the re- 
flex irritability of the spinal 
cord seems to be somewhat 
lessened under the toxic ac- 
tion of the drug. 

Stimulation of some por- 
tions of the vaso-motor and 
pneumogastric nerves seems 
to take place, as we shall ex- 
plain more fully when treat- 
ing of the influence of digi- 
talis over the heart. 



II. Heart and Circulation. 
— Digitalis exerts a decided- 
ly tonic and strengthening in- 
fluence on the heart, render- 
ing its beat slower and more 
forcible, and lengthening the 
period of systole. It therefore 
not only gives rest to the 
wearied organ, but also aids 
its nutrition by enabling the 
coronary arteries to do 
their work by supplying 
blood to the heart's muscle 
more efficiently during the 
prolonged diastolic pause. 
This result seems to depend 



I. Although no direct ac- 
tion is produced on the brain 
tissue, it is reasonable to sup- 
pose that some alteration in 
cerebral function may follow 
the alterations in the vascular 
system produced by digitalis, 
and perhaps this may in part 
explain the remarkable re- 
sults obtained by Mr. Jones, 
of Jersey, in the treatment of 
delirium tremens by the use 
of this drug. He found that 
half-ounce doses of the tinc- 
ture quieted the delirium, 
reduced fever, and caused 
sleep. But this treatment 
can hardly be recommended, 
as several sudden deaths have 
been thus produced, and as 
it seems not improbable that 
the absence of toxic effects 
in many cases is due to the 
very partial absorption of the 
remedy. 

II. The undoubted effect 
of digitalis in slowing and 
strengthening the action of 
the heart would seem to in- 
dicate its use in certain dis- 
eased conditions of the organ, 
but it is only recently that 
this tonic influence has been 
recognized. In former years 
digitalis was looked upon as 
essentially a cardiac sedative, 
and was used to quiet the tu- 
multuous palpitation of hy- 
pertrophy ; but we now know 
that it may be prescribed 
with much greater success 



DIGITALIS. 



287 



partly on a direct action on 
the heart's muscle itself, but 
also in some degree on stimu- 
lation of the cardiac inhibi- 
tory fibres of the vagus, which 
thus hold more forcibly in 
check the rapid rate of pul- 
sation produced by the sym- 
pathetic nerves. If, however, 
the administration of the re- 
medy be too long continued, 
exhaustion of the pneumo- 
gastric is apt to follow this 
overstimulation, and the 
heart, being now handed over 
to the unrestrained power of 
the vaso-motor nerve supply, 
runs riot in excessively rapid 
and feeble contractions. 

The tonic influence of digi- 
talis is attended by well- 
marked rise of arterial ten- 
sion, and this is supposed to 
depend on stimulation of the 
sympathetic centres directly 
supplying the smaller vessels; 
and at the same time the heart 
is induced to act more power- 
fully, to overcome the in- 
creased resistance in front. 



under the following circum- 
stances : — 

1. In palpitation and ir- 
regular action of the heart, 
whether depending on organic 
disease or not, an important 
indication for its use being in- 
termittence, or the occurrence 
of frequent beats which do not 
reach the [radial] pulse. 

2. In mitral disease, where 
the cardiac action is feeble, 
and apparently unable effect- 
ually to propel the blood, 
where lividity and dropsy are 
setting in, the lungs becom- 
ing engorged, and the right 
heart oppressed. 

Here we shall derive the 
most signal service from digi- 
talis given in moderate doses, 
and combined with a little 
iron. Dr. B. Foster ascribes 
some of the good effect of 
digitalis in mitral disease to 
its slowing action, giving 
more time for the auricle to 
empty itself fully of its con- 
tained blood. 

The contracting effect of 
digitalis on the arterioles 
would naturally suggest its 
use in hemorrhage, and it has 
accordingly been found of 
service both in hcemoptysis 
and menorrhagia, although 
in neither is it so efficacious 



3. In dilatation of the 
heart, where the weak and 
thin muscle acts feebly and 
irregularly, giving rise to pal- 



288 



DIGITALIS. 



III. Respiration and Tem- 
perature On respiration no 

effect is produced, and al- 
though, in a state of health, 



pitation and breathlessness, 
and causing temporary bruit, 
by unequal and ineffectual 
closure of the mitral and tri- 
cuspid valves. 

4. In aortic disease, when 
compensation has not been 
made complete by hyper- 
trophy. 

In short, we may use digi- 
talis whenever the heart is 
acting feebly and irregularly, 
but by its use we cannot ex- 
pect to spur on a normally 
constituted heart with sound 
muscle to overcome difficul- 
ties in front, and we must 
avoid its regular use in the 
compensatory hypertrophy of 
aortic disease, and in fatty 
degeneration, where its tight- 
ening effect on the smaller 
vessels throws an injuriously- 
increased amount of work on 
the structurally-damaged or- 
gan. 

5. Ringer has drawn at- 
tention to the beneficial action 
of the temporary use of digi- 
talis in relieving the distress- 
ing attacks of palpitation so 
often due to hypertrophy of 
the heart. 

6. Clifford Allbutt believes 
it to be the best remedy for 
aneurism, given in increasing 
doses, till the pulse comes 
down to 45, and continued 
as long as possible. 

III. Digitalis has been 
found of great service in those 
cases of bronchitis which are 
so frequently associated with 



DIGITALIS. 



289 



digitalis does not lower the 
body heat, it undoubtedly 
possesses this influence over 
febrile conditions ; "YVunder- 
lich and others bringing am- 
ple evidence to prove its 
power of reducing tempera- 
ture in pneumonia, enteric 
fever, acute rheumatism, and 
other acute disorders. 

Binz holds that digitalis 
is no trustworthy antipyretic, 
as its action does not begin 
for thirty-six to sixty hours 
(Traube), and as it is uncer- 
tain and disturbs digestion. 



IV. Digestive and Secret- 
ing Organs. — 1. Stomach 

and Intestines From its 

bitter taste, digitalis might 
be credited with some tonic 
properties ; but it is really 
much more likely to disorder 
than to increase the appetite, 
by causing vomiting. 

It does not seem to affect 
the intestinal tract in any 
way, save in the later stages 
of poisoning, when diarrhoea 
may supervene. 

2. Kidneys Digitalis in- 
creases, under certain condi- 
tions, the flow of urine with- 
out altering in any essential 
respect the quantity or pro- 
portion of its solid ingredi- 
ents. Its diuretic action de- 
pends partly on the tightening 
effect on the arterioles, rais- 
25 



a weak and dilated right 
heart, and where stimulation 
of the cardiac muscle leads to 
a better arrangement of cir- 
culation through the lungs. 

For the reduction of tem- 
perature, digitalis is seldom 
used in this country, but in 
Germany its antipyretic vir- 
tues are prized. It seems, 
however, to lower the body- 
heat without influencing the 
course of the disease ; and as 
it must be given in large 
doses, which may derange the 
digestive functions, even if 
they do not prove directly 
dangerous, there does not 
seem to be any real benefit 
following its employment. 



2. Digitalis is a good diu- 
retic, more especially in car- 
diac and acute renal dropsy, 
and acts best in combination 
with squill and mercury, as 
in the famous Guy's pill. The 
theory of this action, depend- 
ing on heightened blood-pres- 
sure within the Malpighian 



290 



DIGITALIS. 



ing the blood-pressure in the 
renal glomeruli, and partly 
on the increased power and 
regularity of the heart, im- 
proving the general condition 
of circulation within the kid- 
neys. One curious point in 
this connection is, that digi- 
talis will seldom produce diu- 
resis in healthy persons, but 
always acts best when drop- 
sical accumulations have to 
be removed. 

V. Uterus — Digitalis, from 
its action on unstriped mus- 
cular fibre, has the property 
of stimulating the uterus to 
contraction. 



tufts, explains the frequent 
failure of digitalis to aug- 
ment the quantity of the 
urine in chronic kidney-dis- 
ease, where the arterial ten- 
sion is already high. 



V. It has, therefore, been 
used to contract the uterus, 
and thus check flooding or 
Menorrhagia, and it may also 
act by restoring its normal 
functions, when these are sus- 
pended, as in amenorrhea. 



Cautions, Mode of Administration, etc. 

In prescribing digitalis, we are generally advised to sus- 
pend its use from time to time, lest " accumulation" lead to 
poisonous symptoms ; and experience must have shown us 
that, after its prolonged use, uncomfortable symptoms do 
arise. This may be due to elimination from the kidneys 
being prevented in some measure by the contracting influ- 
ence of the drug on the renal arteries, as we find that so- 
called accumulation only takes place when urine is not 
passed freely. 

It is advisable, whilst prescribing the drug, to examine the 
urine from time to time, so as to satisfy ourselves that the 
eliminating functions of the kidneys are being properly 
performed. 

[The well-known variability in the activity of different 
specimens is due in some cases to falsification of the leaves, 
and in other cases to carelessness in gathering them. 
" Good digitalis must be collected when the plant is in full 
flower, selecting only the large lower and root leaves. The 
midribs of the larger leaves should be removed before using 
them." 1 ] 



[i Proc. Am. Phar. Assoc. 1881, p. 137.] 



BITTERSWEET. 291 

As regards the best form for its administration, the 
freshly made infusion is usually preferred. 

R. Tinct. digitalis nix ; or i65 6m. 

Spiritus aeth. nitrosi f.^ss ; " 2 " 

Inf. buchu f§j ; " 32 " M, 

S. Ter in die. 

Recommended by Fothergill in simple cardiac debility 
with scanty flow of urine. 

R. Pulv. digitalis gr. xxx ; or 2f Grn. 

Ferri sulph. exsic. gr. xv ; " 1 " 

Pulv. capsici gr. xl ; " 2,60 " 

Pil. aloes et myrrhae ,^ij ; " 8j " M. 
In pil. lx. div. Una bis iu die. 

Recommended by Fothergill in cardiac debility, gastric 
catarrh, and inactivity of the bowels. 

[The infusion may be combined with a diuretic in cardiac 
dropsy : — 

R. Potassii acetatis er. xxx ; or 2 Grm. 

Inf. digitalis i'5ij; " 8 " 

Aquae q. s. ad f §ss ; " 16 " M. 

In dropsy due to weak circulation. To be taken every 
three or four hours. 

When an alcoholic stimulant is required the compound 
spirit of juniper, or gin, may be added. Aortic disease is 
no contraindication, in such cases, to the use of digitalis.] 

R. Tinct. ferri chloridi tt\,xv ; or 1 Grm, 

Grlycerini f 3 j ; " 4 

Infusi digitalis, 

Syrupi limonis, aa f ^ij ; " 8 

Infusi calumbaa q.s. ad f§j ; " 32 " M. 

S. Ter die sumend. 

The addition of phosphoric acid to this prescription 
would prevent the formation of tannate of iron. 
Cardiac tonic. 



[DULCAMARA— BITTERSWEET. 

The young branches of Solanum Dulcamara, Linne' (N. 0. Solanaceaz). 

Officinal Preparation, U. S. 

Extractum Dulcamaras Fluidum. Dose, f3ss-ij 
(2. to 8. Gm.). 

Dulcamara is a feeble narcotic, formerly recommended in 



292 



ELATERTNE. 



mania, rheumatism, and cutaneous diseases. 
is scarcely used in regular practice.] 



At present it 



ELATERINUM—ELATERINE. 

[A neutral principle extracted from Elaterium, a substance deposited by 
the juice of the fruit of Ecbalium Elaterium, A. Richard (N. 6. 
Cucurbitaceoz) . 



Trituratio Elaterini. 
Gin.).] 

Physiological Actions. 

Elaterine produces irrita- 
tion of the intestine, ending 
in inflammation where in- 
cautiously pushed, and causes 
the evacuation of large quan- 
tities of watery fluid. It 
purges equally powerfully 
when injected below the skin 
or taken by the mouth, but 
it is stated that solution in 
the bile is necessary to de- 
velop its full action. In 
some of the lower animals, 
peculiar nervous symptoms 
follow its use, and vomiting 
and great depression are li- 
able to be produced in the 
human subject even by mode- 
rate doses. 



Dose, gr. |-£ (.05 to .06 



Therapeutical Effects. 

Elaterine is the most pow- 
erful hydragogue cathartic 
with which we are acquainted, 
and as such has been used to 
withdraw watery fluids from 
the intestines in various forms 
of cardiac disease, lightening 
the labors of the heart by 
lessening the volume of the 
blood, and relieving the cel- 
lular tissue and various cavi- 
ties of dropsical accumula- 
tions. As, however, it is 
uncertain and very depress- 
ing in its action, it is now 
rarely used, in comparison 
with compound jalap powder, 
which seems to fulfil the same 
useful indications without an 
equal chance of seriously 
weakening the patient. 



[Elixiria. 

Elixir Aurantii (Simple Elixir) is the only officinal 
Elixir. It is composed of oil of orange, 1 part ; sugar, 100 
parts, with alcohol and water (1 to 3) to make 200 parts of 
filtrate. It is a pleasant vehicle.] 



PLASTERS — ERGOT. 



293 



[Emplastra. 

The officinal Plasters are — 



Emplastruni Ammoniaci 



cum Hy- 
Arnicse [drargyro 
Asafoetidae 
Belladonnae 
Capsici 
Ferri 
Gralbani 
Hydrargyri 



Emplastrum Ichthyocollse 



Opii 

Picis Burgundicse 
" Canadensis 
" cuinCantharide 

Plumbi (Diachylon 

Resinse plaster) 

Saponis.] 



ERGOTA— ERGOT (ERGOT OF RYE). 

[ The sclerotium of Claviceps purpurea, Tulasne (N. 0. Fungi), replac- 
ing the grain of Secale cereale, Linnt (N. 0. Graminaceoe). 

Officinal Preparations, U. S. 

Extraetum Ergotffi Fluidum. Dose, r^x-f3ij 
(.65 io 8. Gm.). 

Vinum Ergot® (15 per cent.). Dose, f 3ss-iv (2. to 
16. Gm.). 

Extraetum Ergot®. Dose, gr. v-x (.30 to .65 Gm.)] 

External Action. 
Ergot has no local action. 

Internal Actions. 



Physiological. 

1. On Nervous System 

No special action on any part 
of the nervous system has 
been proved save some an- 
aemia of the nerve-centres 
caused by vascular contrac- 
tion. 



25 : 



Therapeutical. 

1. Dr. Brown-Sequard ad- 
vises the use of ergot in some 
forms of paraplegia, unat- 
tended by irritation, and 
where inflammatory symp- 
toms have subsided, believing 
that it acts well by contract- 
ing the dilated vessels. Dr. 
Crichton Browne has recently 
prescribed ergot with success 
in some forms of chronic 
mania. [It has been used 



294 



ERGOT. 



2. On Vascular System 

Ergot slightly depresses the 
action of the heart, and re- 
duces the number of its pul- 
sations, and it is said that the 
arterial tension is at first low- 
ered in some slight degree. 
This effect, however, rapidly 
passes away, and a decided 
rise in arterial tension follows 
the contracting influence of 
the drug on the arterioles. 
On examining the web of an 
ergotized frog's foot, we may 
distinctly observe the gradual 
contraction of the smaller 
vessels up to absolute oblite- 
ration of their calibre ; and 
this is believed to be due to 
a primary action of the ergot 
on their muscular walls rather 
than to the intervention of 
the vaso-motor system. Thus 
we observe a direct contrast 
to the action of the nitrite of 
amyl. 



3. Respiration and Tem- 
perature. — No special action. 



in whooping cough, with as- 
serted good results.] 

2. Ergot is now allowed to 
be by far the best astringent 
in cases of internal hemor- 
rhage, and more especially 
in menorrhagia, haemoptysis, 
and epistaxis, the use of the 
liquid extract having quite 
superseded the older treat- 
ment by means of acids (gal- 
lic acid and the like), whilst, 
if a more rapid action is re- 
quired, we may subcuta- 
neously inject ergotine. [It 
has also been injected into 
internal hemorrhoids with 
success.] 

It is also a valuable remedy 
in purpura. Von Langen- 
beck, of Berlin, has advo- 
cated the injection of ergotine 
for the obliteration of aneur- 
ismal sacs, but sufficient evi- 
dence has not yet been brought 
forward of the success of this 
practice; and it has also been 
advised in the case of old 
varicose veins. The gan- 
grenous form of ergotismus 
is doubtless due to arterial 
contraction cutting off the 
supplies of blood to the ex- 
tremities. It has been highly 
praised by Da Costa in dia- 
betes insipidus, and albumi- 
nuria. 

Da Costa considers ergo- 
tine the most effectual remedy 
for the night sweating of 
phthisis. 



ERGOT. 



295 



4. Urinary Functions — 
Ergot, from its specific action 
on unstriped muscular fibre, 
tends to contract the bladder, 
and, by raising the tension 
in the Malpighian bodies of 
the kidneys, it increases the 
urinary flow. 



5. Digestive Organs. ■ — 
Ergot occasionally causes 
sickness, vomiting, and diar- 
rhoea ; but constipation is 
more likely to follow its use, 
from its contracting influence 
on the intestinal capillaries. 

6. Uterine Functions. — 
Ergot has a remarkable and 
almost selective influence on 
the uterus, contracting its 
muscular walls, promoting its 
functions, and encouraging 
the expulsion of its contents. 



4. Ergot has been used 
successfully, and more espe- 
cially when combined with 
iron, in that most trouble- 
some affection, incontinence 
of urine ; but in my own 
experience, belladonna is 
more deserving of confidence. 
Ergot has been recommended 
as a diuretic, and Langen- 
beck has much faith in sub- 
cutaneous injection of ergot- 
ine in the atony of the bladder 
and enlarged prostate, met 
with in the old. 

5. Ergot has been success- 
fully prescribed in cases of 
diarrhcea and dysentery. 



6. Ergot acts as an ecbolic, 
expelling the contents of the 
uterus by causing contraction 
of its muscular walls. It 
must only be used, however, 
where no disproportion exists 
between the child and the 
maternal passages, and where 
we are prepared to render 
instrumental aid at once, if 
necessary, when the pains 
have been aroused. We must 
also remember that its pro- 
longed use is apt to endanger 
the life of the child by cut- 
ting off its supply of blood 
through the placenta. 

Ergot is also of service in 
flooding, in reducing the size 
of hypertrophied or subin- 
voluted wombs, and in pro- 



296 ERGOT. 

moting the destruction of 
submucous polypi, either by 
cutting off their supply of 
blood, or by squeezing them 
out of the uterine cavity. It 
is also an excellent remedy 
for amenorrhcea and some 
forms of leucorrhcea. 

Mode of Administration, Dangers, Cautions. 

In those countries where ergotized rye largely prevails, 
two forms of disease attend its use. 1. The gangrenous 
form of ergotismus, where extensive dry gangrene of the 
nose, face, and extremities supervenes; and, 2. The spas- 
modic variety, where the victim is afflicted with most vio- 
lent and agonizing spasms. [It has been asserted that in 
those places where ergotism occurs, the general hygienic 
conditions are also at fault.] The therapeutic use of ergot, 
however, is of course never productive of any such symptoms, 
and the only inconvenience occasionally observed is some 
digestive derangement with colicky abdominal pain. 

In addition to those named, the three following prepara- 
tions are officinal in the British Pharmacopoeia: — 

Extractum ergotae liquidum [Br.]. Dose, n^x ad f3ij 
(.65 to 8. Gm.). This is apt to be uncertain. 

Infusum ergotae [Br.]. Dose, f^j ad f^ij (32. to 64. Gm.). 

Tinctura ergotae [Br.]. Dose, rt^xad f3.j (.60 to 4. Gm.). 

The powder is also used in doses of from 20 to 30 grs., 
and many experienced authorities recommend a fresh infu- 
sion made with the powder and swallowed. 

Ergotine [which is a purified extract of ergot] may be em- 
ployed by subcutaneous injection, but this process has the 
drawback of causing a painful, black, and unsightly lump at 
the seat of puncture. Sclerotinic acid, however, which is 
the most active principle derived from ergot, may be con- 
veniently used hypodermically. Dose, gr. \ to f (.03 to 
.045 Gm.) 

[Jacoud (Moniteur de la Policlinique, No. 3, 1882) recom- 
mends the following formula: — 



ERYTIIROXYLON. 297 

I£. Ergotini gr. xv ; or 

Grlycerini, 

Aquse dest., aa f5J ; " 

Aq. laurocerasi n\xxx ; " 2 M. 

Of which 20-30 minims are to be injected from two to four 
times a day. 

In phthisical hcemoptysis. 

$. Ergotini gij ; or 8 6m. 

Chloralis gss ; " 2 " 

Aquas destillatse 3vj. " 24 M. 

Inject 16 drops into the gluteal muscle. 

A formula for subcutaneous injection recommended by 
Prof. Simpson. 

I£. Extracti ergotse fluidi f^ij ; or 8|Grm. 

Decocti aloes compositi [Br.] ad igviij ; " | u M. 
Fiat mistura, de qua capiat unciam unam bis in die. 

Useful in amenorrhaea. 

I£. Pulveris ergotae 5.1; or 4 Gm. 

Sacchari ^iv ; " 16 " 

Aqua? bullientis f§iij ; " 96 " 

S. Capiat cochlearia duo magna quarta quaque parte horse ad 
eifectum. 

In a case of labor. [The wine of ergot and the fresh fluid 
extract in doses of 3j-i v are a ^ s0 usec i i n the second and 
third stages of labor.] 

In a case of amenorrhoea from anaemia we may add a little 
ergot to any chalybeate mixture. 



ERYTHROXYLON—ERYTHROXYLON (COCA). 

{The leaves of Erythroxylon Coca, Lamarck (N. 0. Erytlxroxylaceoz.') 

Officinal Preparation, U. S. 

Extractum Erythroxyli Fluidum. Dose, n^xv-5j 
(1 to 4Gm.).] 

The dried leaves of the coca plant, when chewed, are 
valued by some authorities as a nervine and muscular 
stimulant. 

Cocaince hydrochloras, the hydrochlorate of the alkaloid, 
has recently attained a high and well-deserved reputation as 



298 ERYTHROXYLON. 

a local anaesthetic. When applied to the tongue it abolishes 
taste and tactile sensibility, and when a four percent, solution 
is dropped into the eye it enables cataract operations, and 
those affecting the cornea alone, to be done painlessly, and 
materially reduces if it does not remove the pain of operation 
on the iris and the muscles of the eye as well as on the lach- 
rymal apparatus. 

" It appears to act essentially as a stimulant to the sympa- 
thetic system of nerves, in consequence of which it effects 
dilatation of the pupil, constriction of the bloodvessels, dimi- 
nution of the intra-ocular tension, enlargement of the palpe- 
bral fissure, and protrusion of the eyeball." Its use also 
greatly facilitates laryngoscopic examinations and operations 
about the throat, as well as the uterus and bladder, and in 
supraorbital neuralgia it speedily relieves pain when dissolved 
in oil of cloves and rubbed gently over the affected spot. 
Lamella? cocaniae are made each containing ^^ gr. 

[The " Cocaine habit," so called, has attracted some atten- 
tion lately, owing to the sensational reports of persons who had 
become insane as the result of the excessive use of cocaine 
hypodermically. One physician in Chicago is said to have 
subjected himself and all the members of his family to these 
injections until becoming violently insane he was sent to a 
hospital. It is probably true that he was as proper a subject 
for such treatment at the time he commenced the use of the 
cocaine in this manner, as he was at the close ; the exces- 
sive use of this or any other form of stimulant being 
itself an early manifestation of mental disease. Cocaine 
strongly resembles caffeine in its systemic effects and is pro- 
portionately scarcely more toxic. 

Erythroxylon resembles tea in its action upon the nervous 
system as a stimulant and constructive. It is commonly 
used in combination with alcohol as a wine or cordial, as in 
the well known Yin Mariani and the Elixir Cocae (native) ; 
the latter being made in South America from the recently dried 
leaves, it is believed to contain a volatile principle which is 
missing in the preparation made from the dried leaves after 
shipment. The fluid extract of coca, and alcoholic prepara- 
tions are used during convalescence from acute diseases and 
as a tonic. Prof. Da Costa recommends cocaine as a cardiac 
stimulant in failing circulation and weak heart during 
typhoid fever in doses of gr. ^ every two hours. Cocaine has 
been injected hypodermically to produce local anaesthesia 
during surgical operations.] 






EUCALYPTUS. 



299 



[EUCALYPTUS— EUCALYPTUS (BLUE 
GUM TREE). 

The leaves of Eucalyptus Globulus Labillardifa-e (N. 0. Algrtaceoe), 
collected from rather old trees. 

Officinal Preparations. 

Oleum Eucalypti. Dose, n^v-xx (.30 to 1.30 Gm.). 
Extraetum Eucalypti Fluidum. Dose, niij-xx 
(.20 to 1.30 Gm.). 

Local Effects. 



It has some antiseptic pro- 
perties. 



Aqua Eucalypti has been 
used as an application to ul- 
cers, and for inhalation in 
phthisis. 



Constitutional. 



It increases the quantity of 
blood sent to the brain, and 
in large doses causes cerebral 
congestion. 

The heart becomes more 
rapid in its action, and blood 
pressure is reduced. 

Small doses promote appe- 
tite and digestion by stimu- 
lating the salivary and peptic 
glands ; they also increase 
the intestinal secretions. 
Large doses cause vomiting, 
diarrhoea, indigestion, and 
muscular prostration. 

It is an expectorant, and 
large doses cause death by 
respiratory failure. 

The volatile oil is thrown 
off by the kidneys, bronchial 
mucous membrane, and the 
skin. 



In nervousness, hysteria, 
and chorea, the volatile oil of 
Eucalyptus acts as a stimu- 
lant. In malarial manifesta- 
tions it can take the place of 
cinchona when the latter has 
to be discontinued. 

In con valescence from acute 
diseases, in atonic dyspepsia, 
and intestinal catarrh, and 
disorders of digestion. 



In bronchitis and bron- 
chorrhcea it may be adminis- 
tered internally or used by 
inhalation with steam atom- 
izer. In asthma, Eucalyptus 
may be mixed with bella- 
donna, or stramonium leaves, 
and cigarettes made, to be 



300 EUONYMUS — THOROUGHWORT. 

burned and the smoke in- 
haled. 

The water of Eucalyptus (not off.) is used as a vehicle for 
dissolving alkaloids for hypodermic use, to prevent the de- 
velopment of germs of decomposition.] 



EUONYMUS— EUONYMUS (WAHOO). 

[ The bark of Euonymus Atropurpureus, Jaquin ( N. 0. Celastraceoz) . 

Officinal Preparation. 

Extractum Euonymi. Dose, gr. ij to v (.13 to 32 
6m.).] 

Wahoo is cathartic, resembling rhubarb in its action, and 
has decided cholagogue effects. The preparation known as 
Euonymin is a powerful hepatic, but a feeble intestinal, stimu- 
lant, in doses of gr. ss-v. [Consists of resin and fixed oil, 
together with the peculiar bitter active principle, which has 
also received the name of Euonymin. J 



[EUPATORIUM— THOROUGHWORT. 

Hie leaves and flowering tops of Eupatorhim perfoliatxim, Linne (iV. 0. 
Composite) . 

Officinal Preparation, U. S. 

Extractum Eupatorii Fluidum. Dose, 3»s-j (2 
to 4 Gm.). 

Thorough wort (Indian Sage, or Boneset) is a bitter tonic 
and sudorific, and in large doses produces vomiting and 
purging. The hot infusion has been largely given for 
"co/e?s," muscular rheumatism, and catarrh. The infusion 
is emetic in doses of a pint. Dose of the powder as a tonic, 
in dyspepsia, gr. xx-xxx (1.30 to 2. Gm.).] 



EXTRACTS. 



301 



[Extracta. 



The officinal Extracts are — 

Extractum Aconiti Extract 

" " Fluidum " 

" Aloes Aquosum " 

" Arnicse Radicis " 

" " " Fluidum " 

" Aroniaticum Fluidum " 

" Aurautii Amari Fluidum " 

" Belladonna? Alcobolicum " 

" " Fluidum " 

" Brayerae Fluidum " 

" Bucliu Fluidum " 

" Calami Fluidum " 

" Calumbae Fluidum lt 

" Cannabis Indicae " 

" " " Fluidum " 

'• Capsici Fluidum " 

" Castaneae Fluidum " 

" Cbimapbilae Fluidum " 

" Chiratae Fluidum " 

" Cimicifugse Fluidum " 

" Cincbonae " 

" " Fluidum " 

Colchici Radicis " 

" " Fluidum " 

" Seminis Fluid. " 

' ' Colocyntbidis ' ' 

" " Compositum " 

" Conii Alcoliolicum " 

" " Fluidum " 

" Corn us Fluidum " 

" Cubebse Fluidum " 

" Cypripedii Fluidum " 

" Digitalis " 

" " Fluidum " 

" Dulcamaras Fluidum " 

' ' Ergotse ' ' 

" " Fluidum " 

'■ Erytbroxyli Fluidum " 

" Eucalypti Fluidum " 

' ' Euony mi ' ' 

" Eupatorii Fluidum " 

Frangulae Fluidum " 

Gelsemii Fluidum " 

Gentianae " 

Fluidum - 

" Geranii Fluidum " 

Glycyrrbizas " 

" Fluidum " 

26 



um Glycyrrbizae Purum 
Gossypii Radicis Fluid. 
Grindeliae Fluidum 
Guaranas Fluidum 
Hasmatoxyli 
Hamamelidis Fluidum 
Hydrastis Fluidum 
Hyoscyami Alcobolicum 
Hyoscyami Fluidum 
Ipecacuanhas Fluidum 
Iridis 

" Fluidum 
Juglandis 
Kramerias 

" Fluidum 

Lactucarii Fluidum 
Leptandras 

" Fluidum 

Lobelias Fluidum 
Lupuliuse Fluidum 
Haiti 

Matico Fluidum 
Mezerei 

" Fluidum 
Nucis Vomicae 

" " Fluidum 

Opii 

Pareiras Fluidum 
Physostigmatis 
Pilocarpi Fluidum 
Podopbylli 

" Fluidum 

Pruni Virginianas Fluid. 
Quassias 

" Fluidum 
Rhei 

" Fluidum 
Rbois Glabrae Fluidum 
Rosas Fluidum 
Rubi Fluidum 
Rumicis Fluidum 
Sabinae Fluidum 
Sanguinarias Fluidum 
Sarsaparillas Composi- 
tum Fluidum 
Sarsaparillas Fluidum 
Scillas Fiuidum 
Scutellariae Fluidum 



302 OX-GALL — IRON. 

Extractum Senegse Fluidum Extractum Tritici Fluidum 

" Sen 11 as Fluidum " Uvse Ursi Fluidum 

" Serpentarise Fluidum " Valerianse Fluidum 

" Stillingise Fluidum " Veratri Viridis Fluidum 

" Stramonii " Viburni Fluidum 

" " Fluidum " Xanthoxyli Fluidum 

" Taraxaci " Zingiberis Fluidum.] 

" " Fluidum 



[FEL BOVIS— OX-GALL. 

The fresh gall of Bos Taurus, Linn4 (Class Mammalia, Order 
Ruminantiaz) . 

Officinal Preparations, U. S. 

Fel Bovis Inspissatum. Dose, gr. x (.65 Gm.). 
Fel Bovis Purifieatum. Dose, gr. v-x (.30 to .65 
Gm.). 

Ox-gall is mildly antiseptic and laxative, assisting in the 
digestion and absorption of fats. It may be given in habit* 
ual constipation, accompanied by clay-colored, fecal dis- 
charges, but is little used.] 



FERRUM— IRON. 

[Metallic Iron in the form of fine bright non-elastic wire. 
(Fe = 55.9.) 

Ferrum Reduetum (reduced Iron, Quevenne's 
iron). Dose, gr. ij (.13 Gm.). 

Officinal Preparations, U. S. 

Ferri Carbonas Saeeharatus (at least 15 per cent. 
Ferrous Carbonate). Dose, v-xx (.30 to 1.30 Gm.). 

Ferri Iodidum Saecharatum (at least 20 per cent. 
Ferrous Iodide). Dose, gr. iij-x (.20 to .65 Gm.). 

Ferri Chloridum. Dose, gr. j-x (.06 to .65 Gm.). 
Also locally as a styptic. 

Liquor Ferri Chloridi. Dose, n^ij to x (.13 to .65 
Gm.). Used in making the Tincture. 

Tinetura Ferri Chloridi. Dose, ni^x-xl (.65 to 
2.60 Gm.). 



IRON. 303 

Ferri Citras. Dose, gr. v-xx (.30 to 1.30 Gm.). 

Liquor Ferri Citratis (35.5 per cent, of anhy- 
drous salt). Dose, n^x-xl (.65 to 2.60 Gm.). 

Ferri et Ammonii Citras. Dose, gr. v-x (.30 to 
.65 Gm.). 

Vinum Ferri Citratis (4 per cent.). Dose, 5j- 
5 v (.4 to .16 Gm.). 

Ferri et Ammonii Sulphas. Dose, gr. iij-xij (.20 
to .75 Gm.). 

Ferri et Ammonii Tartras. Dose, gr. x-xxx (.65 
to 2. Gm.). 

Ferri et Potassii Tartras. Dose, gr. x-xxx (.65 to 
2. Gm.). 

Ferri et Quininae Citras. Dose, gr. v-xv (.30 to 
1. Gm.). 

Liquor Ferri et Quininae Citratis (Quinine six 
per cent.). 

Vinum Ferri Amarum (8 per cent, of Liquor 
Ferri et Quininae Citratis). Dose, 5.j to ^j. 

Ferri et Stryehninae Citras (Strychnine 1 per 
cent.). Dose, gr. iij-v (.20 to .30 Gm.). 

Syrupus Ferri, Quininae et Stryehninae Phos- 
phatum. Dose, 3j (.4 Gm.). 

Ferri Lactas. Dose, gr. ij-x (.12 to .65 Gm.). 

Syrupus Hypophosphitum cum Ferro (1 per 
cent. Ferri Lactas). 

Ferri Oxalas. Dose, gr. ij-v (.12 to .30 Gm.). 

Ferri Oxidum Hydratum. Dose, gr. v (.30 Gm.). 
(As an antidote, gr. xx for each grain of arsenious acid.) 

Ferri Oxidum Hydratum cum Magnesia. 
(Antidotum Arsenici, P. G.) Dose, as above. 

Liquor Ferri Acetatis (33 per cent, of anhydrous 
salt). Used in making : — 

Tinetura Ferri Acetatis (16J per cent, of anhy- 
drous salt). Dose, t^xv-xxx (1. to 2. Gm.). 

Ferri Phosphas. Dose, gr. v-x (.30 to .65 Gm.). 

Ferri Pyrophosphas. Dose, gr. ij-vj (.12 to .40 
Gm.). 

Ferri Hypophosphis. Dose, gr. v-xx (.30 to 1.30 
Gm.). 

Ferri Valerianas. Dose, gr. j-iij (.06 to .20 Gm.). 

Emplastrum Ferri (Ferrum Oxidum 10 per cent.). 

Trochisei Ferri. (Each gr. v of oxide of iron). 



304 IRON. 

Ferri Sulphas. Dose, gr. i-v (.06 to .30 Gm.). 

Ferri Sulphas Exsiccatus. Dose, gr. i-ij (.06 to 
.13 Gm.). 

Ferri Sulphas Praecipitatus. Dose, gr. j-ij (.06 
to .13 Gm.). 

Mistura Ferri Composita. Dose, fgss (.16 Gm.). 

Massa Ferri Carbonatis (Vallet's Mass). Dose, gr. 
x-xx (.65 to 1.30 Gm.). 

Pilule Ferri Composite. Dose, 2 to 6 pills. 

Pilula? Ferri Iodidi (each contains gr. j of Ferrous 
Iodide). Dose, 1 or 2 pills. 

Syrupus Ferri Iodidi (10 per cent.). Dose, n^x-xl 
(.65 to 2.60 Gm.). 

Syrupus Ferri Bromidi (10 per cent.). Dose, 3ss-j 
(2. to 4. Gm.). 

Liquor Ferri Nitratis (6 per cent.). Dose, ni,x- 
xx (.65 to 1.30 Gm.). 

Liquor Ferri Subsulphatis (43.7 per cent, of basic 
Ferric Sulphate). (Monsel's Solution.) Dose, TTLij-x (.12 
to .65 Gm.). 

Liquor Ferri Tersulphatis (28.7 per cent, normal 
Ferric Sulphate). (Used to prepare hydrated sesquioxide of 
iron). 

Mistura Ferri et Ammonii Aeetatis (see Am- 
monia). (Basham's Mixture.) Dose, ^ss (16 Gm.). 

Pilula^ Aloes et Ferri (1 grain of each). See Aloes. 

Iron is also used in preparing Potassii Bromidum, Am- 
monii Bromidum, and Ferri Bromidum (officinal only in the 
form of the syrup).] 

Local Effects. 

Physiological. Therapeutical. 

Certain of the stronger In the form of the per- 
preparations of iron are very chloride [chloride], iron is 
astringent, corrugating and one of our most generally 
hardening the tissues by co- used astringents for the ar- 
agulating their albumen ; and rest of hemorrhage, as in 
also contracting the smaller epistaxis, leech-bites, mjlood- 
bloodvessels. ing (injected into the uterus, 

as advised by Dr. Barnes), 
or, in fact, in any variety of 
passive hemorrhage. 






IRON. 



305 



It is also a valuable appli- 
cation to relaxed mucous 
membranes; thus, in many 
forms of sore throat, equal 
parts of tinct. ferri and gly- 
cerine will act well. It forms 
a good injection for leucor- 
rhcea, and is extensively em- 
ployed as an enema for the 
destruction of thread ivorms. 
Velpeau recommended the 
application of a strong solu- 
tion of sulphate of iron to 
the inflamed skin in erysipe- 
las, and Ricord considers 
that tartrate of iron has an 
almost specific influence over 
the destructive ulcerative 
process of syphilitic phage- 
dcena. 



Internal Actions and Uses. 



Physiological. 

1. Brain and Nervous 
System. — Iron has a tonic 
influence over the nervous 
system, but occasionally, in 
plethoric persons, the stronger 
preparations will cause an 
uncomfortable sensation of 
fulness and throbbing in the 
head. 



20* 



Therapeutical. 

1. Iron is much used as a 
tonic in all conditions of 
nervous exhaustion and de- 
bility. Thus, in neuralgia, 
which consists in a weakened 
state of the roots of certain 
sensory nerves, it is invalu- 
able. In chorea, which gene- 
rally coincides with debility, 
and in all cases depending in 
any way on want of nerve- 
tone, it is a remedy of real 
value. As originally pointed 
out by Brown-Sequard and 
confirmed by Hughlings-Jack- 
son, iron does not agree with 
epileptics, increasing the ten- 
dency to fits. Gowers, who 
has carefully investigated this 



306 



IRON. 



2. Circulation and Respi- 
ration Iron acts as a tonic 

to the muscular structures of 
the heart, probably by sup- 
plying the stimulus of a larger 
supply of healthy blood. 

Iron is held to increase the 
plasticity of the blood and to 
increase the red corpuscles by 
passing into and stimulating 
the lymphatic system and en- 
couraging the transformation 
of the lymph globules. Re- 
cent researches have shown 
that no effect of this nature 
is produced on healthy blood, 
but that in anaemia the num- 
ber of red corpuscles is very 
rapidly increased under the 
use of iron as the primary 
effect, without a proportionate 
rise in the hoBmaglobin which 
they contain ; as a secondary 
result, however, the hsema- 
globin also is increased and 
the number of globules may 
then even diminish. 



point, shows that it makes 
many cases worse, has no in- 
fluence on others, but that a 
third class, on the border line 
between epilepsy and hysteria, 
may even derive benefit from 
the action of iron as a ner- 
vine tonic. 

2. This increase in the red 
corpuscles of the blood, and, 
as a consequence, in the ex- 
tent to which these important 
bodies carry out their func- 
tion of bearing oxygen to the 
tissues and finally converting 
it into ozone, explains further 
the marvellous tonic influence 
of iron. The benefit in anae- 
mia very quickly follows this 
actual numerical increase, as 
indicated by Gowers's inge- 
nious and practical modifica- 
tion of Malassez-Hayems's 
method for microscopical 
proof of the augmented num- 
ber by careful daily counting. 
In ancemia, in protracted con- 
valescence from acute disease, 
in general feebleness or de- 
bility, in chlorosis, where it 
also acts by giving increased 
tone to the uterine functions, 
in struma, rickets, secondary 
syphilis, etc., iron forms the 
basis of every method of treat- 
ment. Grainger Stewart 
praises the use of the tinc- 
ture of iron in the cerebral 
ancemia, giddiness, and head- 
ache so often met with in 
valvular disease, more espe- 
cially of the aorta. 



TR0N. 



307 



3. On Secreting Organs. 
— On the stomach, iron acts 
by bracing up the mucous 
membrane, and improving 
the appetite and digestive 
tone. 

Its astringency tends to 
cause constipation. 



3. Here we have another 
explanation of its tonic pro- 
perties. 



This action is utilized in 
the treatment of diarrhoea, 
where some of the more as- 
tringent preparations, as the 
nitrate, are often of service. 

[In ordinary tonic doses, 
the tincture of the chloride 
relieves vesical irritability, 
strangury, and spasmodic 
stricture ; and is much used 
in gleet and chronic BrighVs 
disease.^ 



Urine Iron increases the 

amount of urea given off by 
the urine, and occasionally 
irritates the bladder, causing 
frequency of micturition. 

4. On Temperature Iron 

raises the temperature partly 
by increasing the waste of 
the tissues, but partly also 
in virtue of its ozonizing pro- 
perties. 

Specific Action. 

Iron has a very marked influence in checking erysipelas, 
which must be called specific. We here use the tincture of 
the perchloride [chloride], and give it in doses of from f5ss 
t0 f'5j every three or four hours. It is also of service in 
diphtheria ; and Dr. Russell Reynolds has lately brought the 
evidence of over sixty cases to show that in acute rheumatism, 
given in large doses, it rapidly diminishes the pain and 
fever. 



Mode of Absorption and Elimination. 

The more soluble forms of iron are readily absorbed, and 
become combined as albuminates with the albumen of the 
blood, whilst the solid preparations must first undergo solu- 
tion in the gastric juice. "When they have played their part 
within the organism, they are thrown out principally by the 
faeces, to which they impart a blackish color, but also in some 



308 IRON. 

measure by the pigment of the urine, the skin, hair, nails, 
urine, and by albuminous secretions, such as those of the bile, 
by all mucous and serous membranes. 

Modes of Administration. Drawbacks. 

We have seen that various inconveniences may attend 
the use of iron, such as headache, irritability of bladder, con- 
stipation, nausea, etc., and it further has the disadvantage of 
blackening the tongue and teeth ; but many of these evils 
may be avoided by using the lighter or less astringent prepara- 
tions, such as the citrate of quinine and iron, wine or sac- 
charated carbonate ; or by combining with some aperient, 
and by giving each dose after a meal. The dyspepsia and 
hepatic congestion occasionally following the use of the tinc- 
ture in large doses may best be alleviated by adding one 
grain of the chloride of ammonium to each minim (Grainger 
Stewart). 

But if no contraindication exists, there is no doubt that 
the astringent properties of the per-salts of iron stand us in 
good stead, and, in particular, no preparation is so useful on 
the whole as the old muriated tincture. In secondary 
syphilis, the syrup of the iodide is of service, and children 
will always take steel wine or the saccharated carbonate 
well ; whilst in cases of chlorosis with disordered menstrual 
function we shall find the mist, ferri composita to be very 
efficacious in improving the quality of the blood and gently 
stimulating the uterus to resume its neglected duties. The 
sulphate of iron has some influence in aiding the action of 
some purgative salts, as the sulphate of magnesia. 

The preparations of iron are so very numerous that no one 
but a student on the very brink of an examination would 
think of burdening his memory with them all ; and we shall 
only refer, therefore, to those which form part of the daily 
stock-in-trade of the practical physician. 

Dialysed iron (liquor ferri dialysatus) has recently come 
into fashion, and is said to be effective and well borne as a 
tonic in dose of n^v-xx, whilst we are told that it is a good 
and readily procurable antidote in cases of arsenical poisoning. 

Vinum ferri amarum may be given in doses of from f 5j to 
f^j; mistura ferri aromatica [Br.] f^j ad f^ij ; mistura 
ferri composita fjfss ad f^ij ; ferri carbonas saccharatus 
gr. v ad 3j ; syrupus ferri iodidi n^x ad 13j ; ferri et am- 



FIG — FENNEL. 309 

monii citras gr. v ad x ; ferri et quininae oitras gr. v ad xx. 
Or in combination — 

65 Gm. 



H 


Tincturse ferri chloridi 


m, x ; 


or 






Spiritus cliloroforini 


n\xv ; 


a 


1 




Glycerin! 


f £ss ; 


i i 


2 




Infusi calumbse q. s. ad f §j ; 


a 


32 


S. 


Ter die sumend. 









" M. 

Chalybeate mixture. 

I£. Misturse ferri composite, 

Decocti aloes compositi, [Br. j aa f^jss or 16. Gm. M. 
S. Fiat haustus ter die sumendus. 

R. Magnesii sulphatis £ij ; or 64 Gm. 

Ferri sulphatis gr. xxiv ; " 160 

Acidi sulphurici diluti fgij ; "8 

Infusi calumbse q. s. ad f.^viij ; " 256 

S. Capiat cochlearia duo magna omni mane. 

Ferruginous aperient. 

Iron, as a rule, is best taken after a meal, but we must 
warn our patient to avoid the neighborhood of tea, as the 
mixture of these two ingredients forms a species of ink, which 
is both nauseous and unsightly. As the more astringent 
preparations not only stain but injure the teeth, they may 
be conveniently sucked through a glass tube. 



FICUS-FIG. 

[ The fleshy receptacle of Ficus Carica, Linne" (N. 0. Urticacece, 
Artocarpece) , bearing fruit upon its inner sui face. 

Figs are slightly laxative, and enter into Confectio Sennae.] 



[FCENICULUM— FENNEL. 

The fruit of Fceniculum Vulgare, Gcertner (N. 0. Umbellifera, Ortho- 
spermai) . 

Officinal Preparations, U. S. 

Oleum Fcenieuli. Dose tt^v-xv (.30 to 1. Gm.). 
Aqua Fcenieuli. As a vehicle. 

Also enters into Infusum Sennae Compositum, Pulv. 
Glycyrrhizae Compositus and Spiritus Juniperus Compositus. 

Often used in infusion as an aromatic carminative for 
flatulent colic in infants.] 



310 FRANGULA — NUTGALL. 



[FRANGULA—FRANGULA (BUCKTHORN). 

The bark of Rhamnus Frangula, Linne (N. 0. Rhamnacece), collected 
at least one yea?' before being used. 

Officinal Preparation, U. S. 

Extractum Frangulae Fluidum. Dose 3ss— ij (2. 

to 8 Gm.). 

A purgative resembling senna ; the fluid extract is the 
best form for administration, and may be combined with 
aromatics.] 



GALBANUM— GALBANUM. 

[A gum resin from Ferula Galbanifua, Boissier et Bushe, and probably 
from other allied plants (N. 0. Umbelliferce, Orthospernue.) 

Dose, in substance, gr. x-xx (.65 to 1.30 Gm.). 

Officinal Preparations. 

Emplastrum Galbani (Galbanum 16 parts, contain- 
ing also turpentine, Burgundy pitch, and lead plaster). 

Emplastrum Asafcetida? (Asafetidae 35, galbanum 
15 parts). 

Pilule Galbani Composite (each, galbanum, gr. jss ; 
myrrh, gr. jss ; asafcetida, gr. ss.).] 

Galbanum and ammoniacum are substances of no special 
theoretical value [but are usually classed as expectorants, 
antispasmodics, and stimulants.] 



GALLA— NUTGALL. 

[Excrescences on Quercus Lusitanica, Webb, Variety infectoria, De 
Candolle (N. 0. Cupuliferm) caused by the punctures and deposited 
ova of Cynips Galloz Tinctorial, Olivier (Class Insecta, Ord. Hy- 
menoptera). 

Officinal Preparations, U. S. 

Tinetura Gallse (20 percent.). Dose, 3 ss -ij ( 2 to 8 
Gm.). 

Unguentum Gallffi (10 per cent.). 

Acidum Gallicum. Dose, gr. v-xx (30 to 1.30 
Gm.). 



NUTGALL. 



311 



Unguentum Aeidi Gallieae (10 per cent, with 
benzoinated lard). 

Aeidum Tannicum. Dose, gr. j-iv (.06 to .25 Gm.). 
Unguentum Aeidi Tanniei (10 per cent.). 
Trochisei Aeidi Tanniei (each gr. j). 

Galls contain about 50 per cent, of tannic acid, which is 
chemically an anhydride of gallic acid, and yields gallic acid 
by maceration in water. Their action can be best studied 
as tannic acid, to which their astringency is due.] 



Externa 

Physiological. 

Tannic acid has a powerful 
local astringent action, owing 
partly, no doubt, to its power 
of coagulating albumen, and 
" tanning," in some degree, 
any part to which it may be 
applied. 



l Action. 

Therapeutic. 

Tannic acid is a better 
topical astringent than gal- 
lic, and may be used to arrest 
hemorrhage, or diarrhoea, or 
as an injection for gonorrhoea 
and leucorrhcea. Combined 
with glycerine, in the form 
of the glycerite of tannin, it 
is very useful as an appli- 
cation in various forms of 
sore throat, and to arrest the 
discharge in some chronic 
affections of the os uteri, in 
the chronic-weeping stage of 
eczema, in ozcena, and chronic 
otorrhcea. Tt may also soothe 
and restrain some of those 
irritable coughs which de- 
pend on chronic irritation 
about the pharynx. Galls 
are used, in the form of oint- 
ment, as an application to 
haemorrhoids. 



Internal Action. 

Tannic and gallic acids are Tannic acid is rarely used 

both powerful astringents, internally, but gallic acid is 

but as tannic acid is rapidly serviceable in various forms 

converted in the system into of hemorrhage, such as lice- 



312 NUTGALL. 

gallic acid, it is preferable to moptysis, kcematemesis, and 
use the latter. This convic- Menorrhagia ; but in all of 
tion is proved by the fact that these it must yield the palm 
if we take the urine of a pa- to ergot, and it is more espe- 
tient to whom tannic acid has cially in hemorrhage from 
been given, we find that it the kidney that its curative 
will not precipitate gelatine, action comes into play. It 
but that it strikes a blackish has also been used with sue- 
tint with the persalts of iron, cess to check the excretion 

of albumen in chronic renal 

disease. 

$. Acidi gallici gj ; or 4 Gm. 

Glycerini f §ss ; " 16 " 

Aquae destillatae f §vj ; " 192 " M. 

S. f §j ter die, or, better, every three hours, as the acid is 
very rapidly eliminated unchanged by the urine. 

[As tannin in the usual form of solution or in substance 
is only slowly absorbed by the mucous membrane of the in- 
testinal tract, Dr. Lewin 1 recommends its administration in 
solution in the form of an albuminate, which tastes better 
and is more easily absorbed ; thus he uses : — 

Gm. 



$. Acidi tannici 2 

Aquas 100 

Misce, agitando, et adde — 

Sol. album, ovi unius 10 



M. 



The quantity of the albumen must, if necessary, be in- 
creased so as to correspond with the tannic acid. 

For a long-continued administration, the following is 
better : — 

$. Acid, tannici 2 to 5|Gm. 

Aquae destillatae 100J " 

Misce et adde — 

Album, ovi unius. 

Solutio sodii bicarb, q. s. ut ft. solutio limpida. 



M. 



Or, simply :- 



R. Acidi tannici 1 to 5|Gm. 

Aquae 150| " 

Solutio sodii bicarb, q. s. ad react, alkalin. M. 

Which should be kept well corked, and not used until it 
has stood 24-48 hours.] 

i Deutsche Med. Woch. No. 6, 1881. 



PARTRIDGE-BERRY — GELSEMIUM. 313 

[GAULTHERIA— PARTRIDGE-BERRY. 

The leaves of Gtwltheria procumbens, Linne (N. 0. Ericacem), 

Officinal Preparations, U, S. 

Oleum Gaultherise. Used for flavoring. 
Spiritus Gaultheriae, " " 

Used in Syrupus Sarsaparillae Compositus, and Trochisci 
Morphinse et Ipecacuanhas 

Winter- green, or tea-berry, is an aromatic astringent tonic, 
but is chiefly used as a flavoring addition to mixtures.] 

Oil of winter-green is an excellent remedy in acute rheu- 
matism, and is said to possess the virtues of salicylic acid 
without its drawbacks, being prompt, efficient and agree- 
able, and under its use relapses are less common. It is also 
of service in chronic cases, and as a topical application. 
Large and frequent doses must be given — rrr,x in an emul- 
sion with glycerine and water [or simply dropped on 
sugar] . 



GELSEMIUM— GELSEMIUM (YELLOW 
JASMINE). 

[The rhizome and rootlets of Gelsemium sempervirens, Alton (iV. 0. 
Lioganiaceix. .) 

Officinal Preparations, U. S. 

Extraetum Gelsemii Fluidum. Dose, gtt. tn,ij-x 
(.13 to .65 am.). 

Tinctura Gelsemii (15 per cent.). Dose, n^v-xx 
(.32 to 1.30 Gm.). 

An alkaloid, gelsemina, exists in the root ; in combination 
with gelsiminic acid.] 

Constitutional Action. 

Physiological. Therapeutical. 

1. Brain and Nervous 1. Gelsemium has been 

System — Moderate doses pro- prescribed with success in 

duce redness of the conjunc- neuralgia of the fifth nerve, 

tiva, pain in the eye-lids, con- intercostal and ovarian neu- 

traction of pupils followed by ralgia, and myalgia, 
27 



314 



GELSEMIUM 



slight ptosis, whilst large 
closes of'gelsemium cause ver- 
tigo and double vision. [The 
cerebral effects are explained 
by the accumulation of car- 
bonic acid in the blood se- 
condary to respiratory para- 
lysis, by Bartholow.] A para- 
lyzing influence is exerted 
on the spinal cord, the power 
of voluntary movement being 
finally quite abolished, numb- 
ness and staggering being 
preliminary symptoms. Re- 
flex irritability is also sus- 
pended, the pupil dilates, and 
at a later stage the sensory 
columns of the cord are also 
paralyzed, producing com- 
plete anaesthesia (Bartholow). 
The first nerve affected is 
the 6th at its termination, 
causing paralysis of the ex- 
ternal rectus, and later on the 
3d is also attacked. A curi- 
ous point about its action is, 
that when taken internally it 
contracts the pupil, whereas 
on topical application, rapid 
and full dilatation is produced, 
being complete in from 50 to 
70 minutes. One advantage 
which it undoubtedly has 
over atropine, in addition to 
the swiftness of its effects, is, 
that the resulting diminution 
of accommodation for near 
objects is never so well 
marked, and passes away par- 
tially in 10 or 15, and abso- 
lutely in 30 hours. 

Ringer tells us that large 
doses of the alkaloid [gel- 



Dr. Spencer Thompson has 
treated 40 cases of neuralgia 
successfully by gelsemium, 
pointing out, however, that 
its beneficial action is con- 
fined to affections of the tri- 
facial nerve, and more espe- 
cially to the branches supply- 
ing the upper and lower jaw, 
and particularly the latter, 
and that the dose must be 
ttt^xx of the tincture, repeat- 
ed, if necessary, in 1-| hours. 

[In other disorders of the 
cutaneous nerves, as in pru- 
rigo, gelsemium has been 
successfully applied in dilute 
solution ; and it has been re- 
commended also for rhus pois- 
oning 

ty. Acid, carbol. f 5ss, or 2 Grm. 
Ext.gelsem.fld.f5ij; "8 
Glycerhipe, f^ss, or 16 
Aquse, fgij; "64 

M. Sig. For local application. 

(Dr. Edson, Medical Re- 
cord, July 29, 1882.)] 

This would indicate a cer- 
tain advantage in ophthalmo- 
scopic examinations over 
atropine, which causes much 
annoyance to hard-worked 
people by impairing vision 
for a week or ten days after 
use. 



It has been recommended 
as a remedy for tetanus. 



GELSEMIUM 



315 



semine, of which gr., ^ has 
caused death] at first para- 
lyze, and then excite tetanus, 
which in a short time gives 
way to paralysis. 

2. Heart and Circulation. 
— A slightly weakening effect 
on the heart is noted. [This 
is explained by Ott on the 
view that it diminishes the 
pulse-rate by lessening the 
irritability of theexcito-motor 
ganglia of the heart, and the 
arterial pressure by diminish- 
ing cardiac irritability and 
vaso-motor tonus.] 

3. Respiration and Tem- 
perature The respirations 

become labored, shallow, 
and irregular, from dia- 
phragmatic paralysis, death 
ensuing from asphyxia. The 
temperature falls, probably 
in consequence of the pro- 
fuse perspiration which it 
induces. 

Dose, etc. 

We may give the tincture every three hours, until droop- 
ing of the eyelid, dilatation of the pupil, and muscular lan- 
guor are noted. But, remembering that some persons are 
peculiarly susceptible to its physiological action, we must be- 
gin one dose cautiously, from two to three minims, gradually 
increasing up to twenty or thirty. The dose of the alcoholic 
extract (not off.) is one-half to two grains. [In the treat- 
ment of poisoning by gelsemium, hypodermic injections of 
morphine and atropine, and the use of ammonia, and diffus- 
ible stimulants are necessary, with hot applications and fric- 
tions to the extremities.] 



3. Bartholow recommends 
gelsemium in various forms 
of convulsive or spasmodic 
cough, and in acute inflam- 
mations of the lungs and 
pleura he thinks it may do 
good by diminishing the ac- 
tivity of the respiratory func- 
tions. 



316 GENTIAN — CRANESBILL. 

GENTIANA— GENTIAN. 

[The root of Gentiana Intea, Linni {N. 0. Geutianacece). 

Officinal Preparations, U. S. 

Extraetum Gentian®. Dose, gr. ij-iv (.12 to .25 
Gm.). 

Extraetum Gentianae Fluidum. Dose, rr^x-xxx 
(.6.) to 2. Gm.). 

Tinetura Gentian® Composita (gentian 8, bitter 
orange peel 4, cardamom 2, dilute alcohol 100). Dose, 
f5j_iv (4. to 16. Gm.). 

Gentian is the type of the simple bitters, and is largely 
employed in cases where a tonic of this kind is indicated. 
As it contains no astringent element, it may readily be ex- 
hibited in combination with iron.] 

Gentian and chiretta may be grouped together, as their 
action is almost precisely similar. They are both light, 
agreeable tonics, with pleasant, aromatic, bitter flavor, and 
may be used freely in dyspepsia and debility with loss of 
appetite. Gentian has always, however, been much more 
generally employed than chiretta, and this may be partly 
due to the very agreeable compound preparations of the 
former dru°r. 



[GERANIUM— CRANESBILL. 

The rfuzome of Geranium maculatum, Linn$ {N. 0. Geraniacece). 

Officinal Prefaration, U. S. 

Extraetum Geranii Fluidum. Dose, f'5ss— j (2. 
to 4. Gm.). 

Crowfoot, or cranesbill, is an indigenous astringent tonic, 
containing tannic and gallic acids, and may be used with 
advantage in bowel complaints, and as a styptic. A decoc- 
tion in milk is sometimes given to children.] 



GLYCERIN. 317 



GLYCERINUM— GLYCERIN. 

[A liquid obtained by the decomposition of fats or fixed oils, and containing 
not less than 95 per cent, of absolute Glycerin [C 3 H b (HO){\. 

Officinal Preparations, U. S. 

Glyeeritum Amyli (starch 10, glycerin 90). Exter- 
nally used. 

Glyeeritum Vitelli (fresh yolk of egg 45, glycerin 
55). Externally used. 

Mueilago Tragaeanthae (tragacanth 6, glycerin 18, 
water q. s. to make 100). 

Used also in preparing the officinal Extracta Fluida.] 

This useful substance is almost exclusively used externally. 
It moistens and softens the skin, and when properly diluted 
both prevents and cures the painful and unsightly cracks 
known as " chaps" on the hands. It is a serviceable appli- 
cation, either alone or combined with other drugs, in various 
forms of skin disease. 

It may soothe an irritable cough by moistening the dry- 
ness of the throat, and it is stated to be the most efficient 
means at our command for the prevention of bedsores ; being 
mildly laxative, it has been recommended in piles. In addi- 
tion to this, it forms an excellent vehicle for the solution 
of various drugs, as seen in the glycerites of the Pharma- 
copoeia, having this additional advantage, that its adhesive 
nature enables the active ingredient to remain longer than it 
otherwise would in contact with the affected surface. It is 
also a good solvent of the alkaloids, dissolving them freely, 
and, being decidedly antiseptic, it is now used for preserva- 
tion of vaccine lymph. 

Some remarkable experiments have been recently made 
regarding the physiological action of glycerin. MM. Dujar- 
din-Beaumetz and Audige, working in Vulpian's laboratory, 
found that by hypodermic injection it causes tetanic rigidity 
resembling that caused by strychnine, with rise of tempera- 
ture, hgematuria, and meningeal injection ; and M. Cattillon 
found that internally it increased the appetite, promoted 
nutrition, and lessened the excretion of urea. It would there- 
fore seem to be a good nutrient, although unfortunately of no 
use in diabetes. [Recently glycerin has found favor as an 
enema in the treatment of constipation. Glycerin supposi- 

27* 



318 LICORICE. 

tories with white soap (50 per cent, glycerin) are also 
used.] 

Internal Use. 

It was thought at one time that glycerin might prove an 
agreeable and efficient substitute for cod-liver oil ; but this 
has not been confirmed, and glycerin is now seldom used 
internally. [It has been found of special value in the treat- 
ment of Trichinosis. Dose, 3ij— iv. It has been highly 
commended as a substitute for sugar in the diet of diabetic 
patients. It may be given as a laxative to children. When 
used internally only the purest kind should be used ; that 
made from vegetable fats is considered preferable on this 
account.] 

Boro-Glyceride [a 50 per cent, solution of boric acid 
in glycerin] has been recommended by Barvvell as an anti- 
septic in surgical manipulations and dressing. 

Soak lint in a solution of 1 in 20. 



GLYCYRRH1ZA— LICORICE. 

The root of Glycyrrhiza glabra (2V. 0. Leguminosw, Papiltonacece) . 

Enters into the manufacture of Decoctum Sarsaparilloe 
Compositum, Extractum Glycyrrhizae, Extractum Sarsa- 
parilloe Fluidum Compositum, Infusum Lini Compositum, 
Pilulaa Hydrargyri, and Syrupus Sarsaparillae Compositus. 

Officinal Preparations, U. S. 

Extractum Glycyrrhizae. Licorice. 

Extractum Glycyrrhizae Purum. 

Extractum Glycyrrhizae Fluidum (for flavoring). 

Mistura Glycyrrhizae Composita. Brown mix- 
ture. Dose, 3j-i v (4. to 16. Gm.). 

Trochisci Glycyrrhizae et Opii (each ^ grain of 
opium) [and enters into the Pilulse Ferri lodidi, Tinctura 
Aloes, and Trochisci Cubebas]. 

Glycyrrhizinum Ammoniatum. (To mask qui- 
nine.) 

Pulvis Glycyrrhizae Compositus. Compound lico^ 
rice powder (contains senna, licorice, fennel, washed suh? 
pliur and sugar.) Dose, 5j-ij (4. to 8. Gm.). 



COTTON ROOT BARK — COTTON. 319 

Powdered licorice root is used as a flavoring ingredient, 
and as a basis for powders and pills. The Pulvis Glycyrrhizse 
Comp., in which sulphur now appears for the first time in 
combination with senna and fennel, is an excellent aperient. 

[Licorice is an excellent demulcent, and in the form of 
decoction is used in catarrhal affections and diarrhoea. It 
is largely used as a flavoring ingredient, and ammoniated 
glycyrrhizin is perhaps the best adjuvant to quinine, to 
disguise the bitter taste of that drug. The compound licor- 
ice mixture (brown mixture) contains paregoric (f^ij), 
antimonial wine (f^j), and sweet spirits of nitre (f Jss) in 
each pint (U. S.). It is very commonly used in bronchitis, 
acute and chronic, in combination with ammonium chloride, 
and stimulating expectorants like syrup of senega, or tincture 
ipecacuanha.] 



[GOSSYPII RADICIS CORTEX—COTTON 
ROOT BARK. 

The bark of the root of Gossypium herbaceum, Linne*, and of other 
species of Gossypium (N. 0. Malvaceae). 

Officinal Preparation, U. S. 

Extraetum Gossypii Radieis Fluidum. Dose, 

f3ss-j (2. to 4. Gm.). 



GOSSYPIUM— COTTON. 

The hairs of the seed of Gossypium herbaceum, Linn6, and of other species 
of Gossypium, freed from adhering impurities and deprived of fatty 
matter. 

Officinal Preparations. 

Pyroxylon. Gun Cotton. 

Collodium. Pyroxylon dissolved in ether and alcohol.] 

Absorbent cotton is employed in various inflammatory 
conditions, with the view of excluding air and supplying 
warmth and slight support. Thus in burns, and more es- 
pecially in those of a superficial nature, the immediate appli- 
cation of a thick layer of cotton- wool relieves the smarting 
pain and promotes recovery ; and the same treatment may 
be recommended to a blister after the watery fluid has been 
removed from the bulla. In acute rheumatism, also, the 



320 POMEGRANATE — GRINDELIA. 

patient may derive much relief from the careful and equable 
encircling of his inflamed joints with cotton-wool, secured in 
position by a few turns of flannel bandage. 

It is also believed by some aurists to form the best mate- 
rial for the construction of an artificial membrana tympani. 

[Cotton-root bark as a parturifacient has considerable repu- 
tation throughout the South ; it is used in recent decoction 
or as a fluid extract. It does not appear to have aborti- 
facient powers (Martin, Am. Journ. Med. Sciences, Prize 
Essay), although a valuable oxytocic in tedious labor. 

For Collodium, see page 2G9.] 



GRANATUM—POMEGRANATE. 

[ The bark of the root of Punica Granatum, Linne (N. 0. Granatacece) t 

Physiological Action. Therapeutical Action. 

Pomegranate bark destroys It is much used as an an- 

a tape-worm, according to thelmintic in veterinary prac- 

Kiichenmeister, in three tice [and is sometimes given 

hours. [As it contains gallo- in infusion as a gargle, and 

tannic acid, it should not be as an injection in gonorrhoea . 

prescribed in combination A tape-worm may be dis- 

with metallic salts. It may charged in a few hours by 

be given in the form of the administering the decoction 

fluid extract (not officinal), or through a stomach tube, and 

it may be used in decoction following it by castor oil ; or 

(^ij to Oj), as an astringent by a dose of the Pelletierine 

wash. Pelletierine is the tannate, grs. ss. to J (.03 to 

active principle.] .05 Gm.), taken fasting and 

followed by a purgative.] 



[GRINDELIA— GRINDELIA. 

The leaves and flowering tops of Grindelia Robusta, Nuttall (N. 0. 
Compositce). 

Officinal Preparation. 

Extractum Grindeliae Fluidum. Dose, n^x to 5j 
(.65 to 4 Gm.). 

This has expectorant and antispasmodic powers, and in 
cases of asthma, especially with cardiac disorder, it has decided 
value. It is also given in whooping-cough, hay-fever, etc.] 



GUAIAC-WOOD — GUTTA-PERCHA. 321 



GUAIACI LIGNUM— GUAIAC WOOD. 

The heart-wood of Gitaiaeum officinale, Linne, and of Guaiacum Sanctum, 
Li ane' (N. 0. Zygophyllaceai). 

GUAIACI RESINA— GUAIAC. 

The resin of the wood of Guaiacum officinale, 

Officinal Preparations, U. S. 

Tinctura Guaiaei (20 per cent, of the resin). 
Dose, n\,x-5j (So to 4 Gm.). 

Tinctura Guaiaei Ammoniata (Guaiac 20, Aro- 
matic Spirits of Ammonia 80 parts). Dose, n\,x to 5j 
(.65 to 4 Gm.). 

Also enters into Syrupus Sarsaparillre Compositus, and 
Piluke Antimonii Composite. 

Uses. 

Guaiac is alterative, and is employed in chronic rheuma- 
tism, rheumatoid arthritis, and syphilis. The ammoniated 
tincture is the best preparation, and is usually given in milk. 
The tincture is sometimes very efficient in tonsillitis.] 



[GUARANA— GUARANA. 

A dried paste prepared from the crushed or ground seeds of Paullinm 
sorbiiis, Martins (X. O. Sapinda.cece\. 

Officinal Preparation. 

Extraetum Guarans Fluidum. Dose, n^x-5ij 
(.65 to .8 Gm.). 

Contains Caffeine, to which its usefulness in migraine is 
due, combined with tannic acid, which gives it astringent 
and tonic properties.] 



GUTTA-PERCHA— GUTTA-PERCHA. 

[T/te concrete exudation of Isonandra gufta, Hooker {N. 0. Sapotacefe'). 

Officinal Preparation, U. S. 

Liquor Gutta-Pereha3 (in chloroform 9 per cent.). 
Used externally and for making charta sinapis.] 



322 HjEMATOXYLON — HAMAMELIS. 

Gutta-percha is only adapted for external use, and is of 
service mechanically as a material for splints, being readily 
softened in hot water and moulded to the affected joint or 
limb. It furnishes a cheap and efficient rival to oiled silk, 
and its solution in chloroform forms a good and impervious 
covering in smallpox, erysipelas, and other affections where it 
is of importance to protect the skin from the action of the air. 



H^MATOXYLON— H^EMATOXYLON (LOG- 
WOOD). 

[The heart-wood of Hazmatoxylon Campechianum, lArmi (N. 0. Legu- 
minosce Papilionacem) . 

Officinal Preparations, U. S. 

Decoetum Hsematoxyli. Dose, fgij (64. Gm.). 
Extraetum Ha^matoxyli. Dose, gr. x (.65 Gm.).] 

Physiological Action. Therapeutical Use. 

Logwood has astringent It is an agreeable and 
properties. efficient remedy in diarrhoza, 

and is well taken by chil- 
dren. We must remember 
that it imparts its pink color 
to the feces, and to the urine 
should that secretion chance 
to be alkaline. 

[It may be combined for diarrhoea as in the following 
formula : — ] 

65 Gm. 



M. 



[HAMAMELIS— HAMAMELIS (WITCH-HAZEL). 

The leaves of Hamamelis Virginica, Linne (N. 0. Hamamelacece) , collected 
in autumn. 

Officinal Preparation, U. S. 

Extraetum Hamamelidis Fluidum. niv-3j ( 32 - 
to 4 Gm.). 



R 

S. 


Extracti haematoxyli 

Tincturae catechu 

Syrupi 

A quae carui q. s. 

Ter die sumendus. 


gr. x ; 
f*ss ; 

i5i; 

ad i§j ; 


or 

ti 

a 


2 

4 

16 



HEDEOMA — HOPS. 323 

Is astringent and exerts a special influence over the 
venous system, producing contraction, in hemorrhoids, vari- 
cose veins, and ulcers. 

It has also been used locally in the form of a distilled water 
•for sprains and bruises ; the diluted fluid extract is more 
efficient for this purpose than the proprietary medicine 
usually sold under the name of Witch-hazel Extract.] 



[HEDEOMA—HEDEOMA (PENNYROYAL). 

The leaves and tops of Hedeoma Pulegioides, Persoon (N. 0. Labiates).. 

Officinal Preparation, U. S. 

Oleum Hedeomse. Dose, gtt. ij-x (.12 to .65 Gm.). 

Hedeoma is a gentle stimulant aromatic used in flatulent 
colic, sick stomach, and in amenorrhcea. In recent suppres- 
sion of the menses it is a popular domestic remedy, given in 
warm infusion.] 



HUMULUS— HOPS. 
[ The strobiles of Hamulus lupulus, Linne (N. 0. Urticacece, Cannabinece). 

Officinal Preparations, U. 8. 

Tinctura Humuli (20 per cent.). Dose, f3j-«j (4. 
to 12. Gm.). 

Lupulinum. ( The glandular powder separated from 
the strobiles of Humulus lupulus). Dose, gr. v-xx (.30 to 
1.30 Gm.). 

Extractum LupulinaB Fluidum. Dose, n^x-xv 
(.05 to 1. Gm.). 

Oleoresina Lupulinae. Dose, grs. ij to v (.13 to .32 
Gm.). 

Hops are tonic and probably narcotic, more especially in 
the form of the old-fashioned hop pillow. Internally they 
are rarely prescribed. [They may be used as an anodyne 
cataplasm, either alone or with Indian meal. The prepara- 
tions of lupulin are sometimes administered in delirium 
tremens as a sedative tonic, and hop tea (^ss to the pint) fla- 
vored with capsicum is also given to alcoholic subjects, with 
excellent effects. The bitter malt liquors contain hops ; they 



324 MERCURY. 

are useful as tonics, and are given to increase the flow of 
milk during nursing. They are also valuable in some forms 
of insomnia and in gastralgia.~] 



HYDRARGYRUM—MERCURY (QUICKSILVER). 

[JL shining, silver-white metal, liquid at common temperatures, and having 
the sp. grav. 13.5, Hg : 199.7. 

Officinal Preparations, U. S. 

I. In the Metallic State. 

Hydrargyrum. 

Emplastrum Ammoniaci cum Hydrargyro. 
Emplastrum Hydrargyri (mercury 30 per cent.). 
Hydrargyrum cum Creta (mercury 38 per cent.). 

Dose, gr. v-xxx (.30 to 2. Gm.). 
Massa Hydrargyri (mercury 33^ per cent.). Blue pill. 
Unguentum Hydrargyri (mercury 50 per cent.). 

II. Oxidized. 

Hydrargyri Oxidum Rubrum. 

Unguentum Hydrarg. Oxidi Rubri (10 per cent.). 
Hydrargyri Oxidum Flavum. 

Unguentum Hydrarg. Oxidi Flavi (10 per cent.). 
Oleatum Hydrargyri (10 per cent.), used externally. 

III. Sulphuretted. 

Hydrargyri Sulphidum Rubrum. (For fumigating.) 

IV. As Protoehloride (subehloride ?). 

Hydrargyri Chloridum Mite. Dose, gr. ss-x (.03 to 
.65 Gm.). 

Pilulae Antimonii Coinpositae (calomel 16§ per cent.). 

Piluhe Catharticee Composite (each pill contains calo- 
mel, abstract of jalap, aa gr. j ; ext. colocynth com. 
gr. j^ ; and gamboge, gr. J). Dose, 1 to 4. 

V. As Bichloride (protoehloride ?, perehloride, 
Br.). 

Hydrargyri Chloridum Corrosivum, gr. t V-tV (-004 

to .006 Gm.). 
Hydrargyrum Ammoniatum. Used externally. 
Unguentum Hydrargyri Ammoniati (10 per cent.). 






MERCURY. 325 

VI. With Iodine. 

Hydrargyri lodidum Rubrum (biniodide), gr. ^ (.004 

Gm.). 

Liquor Arsenii et Hydrargyri Iodidi (Donovan's 
Solution). Dose n^v-x (.30 to .65 Gra.). 

Hydrargyri lodidum Viride (protiodide). Dose, gr. £ 
(.015 Gm.). 

VII. With Cyanogen. 

Hydrargyri Cyanidum. Dose, gr. T V-T7 (-005 Gm.). 

VIII. With Acids. 

Liquor Hydrargyri Nitratis (about 50 per cent. 

mercuric nitrate). As a caustic. 
Unguentum Hydrargyri Nitratis (Citrine ointment). 

(Mercury 7, nitric acid 17, lard oil 76.) 
Hydrargyri Subsulphas Flavus. Dose, gr. ^-j> 

(Turpeth Mineral). As an emetic, gr. ij-v (.013 

to .32 Gm.). 

Poisoning. 

In the metallic state, mercury exercises but slight influence, 
but in a state of vapor it is capable of causing violent symp- 
toms. All the salts of mercury are poisonous ; but the most 
important is corrosive sublimate. 

The symptoms caused by corrosive sublimate resemble 
those produced by arsenic, but, from the salt being more 
soluble, they are more immediate and violent ; there is a 
more marked taste, the evacuations are more frequently 
bloody, and there is a whitened condition of the epithelium 
of the mouth. There are three varieties of poisoning with 
mercury. In the first, the leading symptoms are, violent 
irritation of the alimentary tube ; namely, vomiting, purging, 
pain at the pit of the stomach, and irritation in the throat ; 
metallic, styptic taste, corrosion of the mouth, tongue, and 
palate ; constriction of the throat, and difficulty of swallow- 
ing. Blood evacuated both by vomiting and by stools, sup- 
pression of urine, countenance flushed, tumid, and bloated. 
In the second variety, salivation and sloughing of the mouth 
succeed to the irritation and inflammation. In the third, 
mercurial erethism comes on, and is not preceded by the 
symptoms of local irritation. The first variety arises from 
the more soluble salts of mercury, in large doses ; the second, 
from the same preparations, but in smaller doses and more 
28 



326 MERCURY. 

diluted; the third, by the more insoluble and refractory 
compounds. 

Morbid Appearances — These are similar to those attend- 
ant on irritative or corrosive poisoning. There are, fre- 
quently, shrivelling of the tongue, and enlargement of its 
papillae and root. In some cases, red and black spots in the 
interior of the heart. Corrosion, ulceration, and disorgani- 
zation of the mucous coat of the stomach and intestines. An 
inflamed condition of the urinary organs is also frequently 
observed. 

Tests. 

Corrosive sublimate in a solid state is sublimed when 
heated in a test-tube; and the acrimonious fumes speedily 
condense into a crystalline, semi-transparent mass. Placed 
in a test-tube, and lime-water, potassa, or soda added in 
solution, a yellow (peroxide of mercury) precipitate is thrown 
down. 

In solution, ammonia throws down a white (ammonio- 
chloride of mercury) precipitate. Solution of proto-chloride 
of tin affords a precipitate (calomel), which, at first, is white, 
but acquires a leaden color on adding more of the test ; when 
this precipitate (after being well agitated) is dried, minute 
globules of quicksilver may be detected. Transmission of 
sulphuretted hydrogen produces a (sulphuret of mercury) 
precipitate, which at first is leaden-colored, then black. 
Solution of iodide of potassium affords an intensely brilliant 
scarlet {biniodide of mercury) precipitate, which dissolves in 
an excess of the test. Corrosive sublimate may be reduced 
to the metallic state through galvanic influence, applied as 
follows : A drop of the suspected fluid being laid on a piece 
of polished gold, and both it and the gold touched at the 
same instant by a point of iron (as a thick needle, or the 
end of a penknife), a small silvery coating of mercury soon 
becomes apparent on the gold. Being freely soluble in sul- 
phuric ether, addition of this fluid is of much service when 
the poison is found mingled with organic or other matters. 

The cyanide, when heated in a tube, evolves cyanogen 
gas, which will burn with a rose-red flame, with a blue halo. 

Calomel is sublimed by heat. When treated with potassa, 
or lime-water, it assumes a black appearance, mercurous 
oxide being separated. 

On cautious application of heat, the biniodide sublimes in 



MERCURY. 327 

red-colored crystals, which soon change to yellow, and sub- 
sequently to a dusky hue. On exposure to a sufficient degree 
of heat, iodine fumes are disengaged. When mixed with 
potassa (equal weights) and heated in a test-tube, decompo- 
sition occurs; metallic mercury being sublimed, and iodide of 
potassium deposited in the tube. 

When red precipitate is exposed to heat in a test-tube, 
metallic mercury is sublimed, with the evolution of oxygen. 

If the persulphate be treated in the same manner as the 
foregoing, sublimation of the mercury takes place, and sul- 
phurous acid gas is evolved. 1 

Antidotes. 

Acute poisoning produced by corrosive sublimate requires 
albumen (white of eggs, blood, or flour and water) and de- 
mulcents. Milk may be freely drunk, and vomiting encour- 
aged. Gold-leaf and iron-filings form a chemical antidote, 
decomposing the chloride and depositing the mercury. It 
has been stated that the hydrated proto-sulphuret of iron, if 
taken immediately, completely destroys the poisonous proper- 
ties of the corrosive sublimate.] 

Local Actions. 
Physiological. Therapeutical. 

One preparation, the acid The acid nitrate is used as 

nitrate, is a very powerful an application in lupoid ul- 

caustic, in virtue of its free cerations, and in ulcerations 

nitric acid. Salivation has about -the os and cervix uteri. 

occasionally followed its use. Calomel in lime-water 

[When using the acid ni- [3j to Oj] forms the familiar 

trate of mercury as a caustic black-wash which is of great 

to chancroids or other sores, service in venereal ulcera- 

care should be taken to have tions, either primary or secon- 

it diluted with from ten to dary ; and the same salt, in 

twelve parts of water. When the form of powder, may be 

applied stronger it sometimes dusted on condylomata or 

causes very troublesome hem- corneal ulcerations with ad- 

orrhage.] vantage. Corrosive subli- 

Other preparations are oc- mate, in the form of lotion, 

easionallv used externally for often checks troublesome ul- 

1 From Griffith's Formulary. 



328 



MERCURY. 



skin diseases, syphilitic ulcer- 
ations, etc., and in virtue of 
the destructive power which 
they all (but more especially 
corrosive sublimate) exert 
over the lowest forms of ani- 
mal and vegetable life. In 
virtue of this power corrosive 
sublimate is now used to carry 
out the antiseptic process of 
Lister, and in Germany it 
has almost entirely superseded 
carbolic acid for this purpose, 
the great advantages which it- 
possesses over other agents 
being its non-volatility. Mer- 
cury, being readily absorbed 
by the skin, is frequently in- 
troduced into the system by 
this channel. 



cerations of the throat; and 
both this and the various 
forms of mercurial ointment 
are almost infallible reme- 
dies for pedicali or for fawns, 
tinea tonsurans, and other 
skin diseases which are known 
to depend on the presence of 
minute vegetable growths. 
We must remember, how- 
ever, that dangerous symp- 
toms, and even death, have 
occasionally been caused by 
the absorption of the mineral 
when thus applied. 

Many chronic skin dis- 
eases may be well treated by 
citrine ointment. Goitre fre- 
quently yields in India to 
the inunction of the binio- 
dide, and Mr. Marshall has 
highly recommended the 
oleate of mercury as an ap- 
plication to various joint af- 
fections. 

[The biniodide has been 
used as a substitute for cor- 
rosive sublimate in the treat- 
ment of putrid lochia and 
septic poisoning after labor 
(1 to 4000 parts of water), 
used in a douche, repeated ac- 
cording to the urgency of the 
case. It has also been used 
in ophthalmic surgery as an 
antiseptic with good results.] 
The external application 
of mercury, by the calomel 
vapor bath, or blue ointment, 
having for its object the pro- 
duction of constitutional 
effects, will be considered 
further on. 



MERCURY. 



329 



Internal Actions and Uses. 

1. Mercury lias been found 
of most signal service in some 
forms of advanced syphilitic 
disease affecting the brain. 



1 . Brain and Nervous Sys- 
tem. — Mercury, pushed up to 
the development of poisonous 
symptoms, produces a curious 
condition of nervous debility 
and tremors, which is occa- 
sionally met with in work- 
men who have been freely 
exposed to its fumes in silver- 
ing glass. 

2. Circulation and Respi- 
ration One form of mer- 
cury, the perchloride, or cor- 
rosive sublimate, acts as a 
cardiac poison, distinctly low- 
ering the action of the heart, 
but the other preparations 
have no such influence. Mer- 
cury causes anasmia by de- 
stroying the red corpuscles of 
the blood. It has long been 
observed that they become 
spheroidal and of deeper hue, 
have less cohesion, and finally 
dissolve. The blood becomes 
more fluid, and the fibrine 
less coagulable. [But in mi- 
nute doses, gr. T ^ to T ^, 
given thrice daily for a length 
of time, corrosive sublimate 
acts as a tonic and increases 
the number of the red-blood 
corpuscles, particularly in 
syphilitic ancemia.~\ 

3. Secreting Organs — Sto- 
mach and Intestines Mer- 
curial preparations, and more 
especially calomel, act as 
purgatives, causing repeated 
grayish or greenish evacua- 
tions; the duodenum being 



2. An exception to this 
general rule must be noted 
in secondary syphilis, with 
anaemia, where mercury un- 
doubtedly increases the pro- 
portion of the red to the 
white corpuscles. Mercury 
has been strongly recom- 
mended as removing conges- 
tive oedema, and promoting 
the absorption of exudations 
in some forms of bronchitis. 



28* 



3. Experience demonstrates 
that the form of vomiting com- 
mon in children, where the 
stomach rejects everything 
suddenly and violently, ^ gr. 
of hyd. cum creta or £ gr. of 
calomel every hour, will often 



330 



MERCURY. 



the portion of the gut pri- 
marily acted upon. The ac- 
tion of mercury on the liver 
has provoked a good deal of 
controversy. 

Calomel and blue pill are 
frequently used as adjuncts 
to other purgative drugs. 



Kidneys Mercury, and 

more especially blue pill, has 
the power of promoting the 
action of diuretics. 

Saliva Mercury is well 



cure, as Ringer has shown. 
Minute doses of the perchlor- 
ide are also useful in dysen- 
teric diarrhoea. 

Clinical evidence has most 
distinctly proved, not only 
that the well-known symp- 
toms of biliousness may be 
most effectively removed by 
the old-fashioned blue pill 
and black draught, but that 
an increase of bile may also 
be thus produced in the mo- 
tions. This has been ex- 
plained by the irritating in- 
fluence of the mercury on the 
duodenum, and the conse- 
quent sweeping away of the 
secreted bile which, under 
ordinary circumstances, is 
well known to undergo re-ab- 
sorption from the intestines. 

Mercury has been supposed 
also to act by stimulating the 
gall-bladder to contract. But 
the careful experiments of 
Rutherford have proved that 
whilst calomel stimulates the 
intestinal glands, but not the 
liver, corrosive sublimate is a 
powerful hepatic, but a feeble 
intestinal stimulant. 

There is no foundation for 
the belief that calomel acts 
by being converted, through 
the action of the gastric juice, 
into corrosive sublimate. 

Thus, in the form of Guy's 
pill, containing blue pill, 
squill, and digitalis, we ob- 
tain a most marked diuretic 
effect. 

The old-fashioned notion is 



MERCURY. 



331 



known to stimulate the action 
of the salivary glands, large 
quantities of their secretion 
being poured out when the 
drug is pushed far enough. 
The fluid, at first thick and 
containing much albumen, 
subsequently becomes thin 
and watery. 

Skin. — Inunction of ung. 
hydrargyri is apt to bring out 
a crop of irritable pimples, 
and one of the symptoms of 
mercurial poisoning is an ec- 
zematous eruption. 

Mercury is supposed to 
stimulate absorption by ren- 
dering effused fibrine less co- 
hesive, by promoting its dis- 
integration, and by retarding 
cell-growth. 



now happily exploded, that 
we must measure efficacy of 
our mercurial treatment by 
the amount of salivation, our 
object being always to stop 
short at any evidence of in- 
creased salivary secretion. 



Mercurial ointments are 
useful as stimulants in many 
chronic skin affections as well 
as in pruritus and pityriasis 
of the scalp. 

Mercury was accordingly 
invariably given, in former 
days, in all cases where any 
effusion of fibrine was sup- 
posed to have taken place, 
such as the second stage of 
pneumonia. 



Specific Action. 

Mercury may be said to act as a specific, or at least as a 
true vital antidote, in syphilis, and more especially in the 
primary and secondary stages of that insidious malady. 
When we are satisfied that we have to deal with an infect- 
ing sore, the sooner we begin our mercurial treatment the 
better ; and it is well to push it in small doses for a consid- 
erable time, until the gums are slightly affected. For this 
purpose moderate doses of blue pill and opium are perhaps 
the most effectual; but we may also derive much benefit now 
and then from rubbing in 3 SS t0 3j °f °l ue ointment, night 
and morning. The whole train, also, of secondary eruptions 
of the skin, sore throat, condylomata, iritis, etc., must also 
be subjected to mercurial treatment, and the calomel vapor 
bath and the bichloride of mercury will here do us good 
service. 

It is doubtful whether, by the most careful and scientific 
treatment of a primary sore, we can altogether prevent the 
development of secondary symptoms ; but if we cannot do 



332 MERCURY. 

this we can at least postpone them, and render them less 
severe, and also lessen the probability of tertiary mischief. 
In order to get the most satisfactory results, we must con- 
tinue a careful administration of mercury for many months, 
and if this be done, there seems no doubt that syphilis can 
be readily cured, or finally be eradicated from the system. 

In the congenital syphilis of young children, the local ap- 
plication of a little blue ointment, either rubbed into the 
skin or smeared over a bit of flannel wound round the waist, 
is eminently satisfactory in its results. 

Mercury was formerly believed to have a specific influence 
in checking the inflammations of serous membranes, and was 
consequently invariably used in peritonitis, pericarditis, and 
pleurisy; but faith in this conviction has been a good deal 
shaken of late, and the conventional calomel and opium does 
not so often appear in prescriptions as formerly. 

On the continent much importance is attached to consid- 
erable doses of calomel in the early stages of typhoid fever, 
but statistics do not seem to prove any decided advantage as 
accruing from this mode of treatment. 

Drawbacks, Cautions, etc. 

It is important to be familiar with the signs which indi- 
cate when the mercurial treatment has been carried far 
enough. The gums generally give the first token in a deli- 
cate red line running along their margin, followed by pulpy 
thickening of the interdental portions, and finally retraction 
from. the teeth. To this succeeds a metallic taste in the 
mouth, an increased flow of saliva and a peculiar fetor of 
breath, and we generally find that the very slightest " touch- 
ing" of the gums is sufficient to show that the physiological 
effect of the mineral has been attained. 

fit should be remembered that salivation comes on rather 
slowly and sometimes appears a day or two after the admin- 
istration of the mercurial has been suspended ; showing that 
the system may be fully influenced by the remedy for at 
least twenty-four hours before its specific action on the mouth 
is apparent.] 

Whilst a patient is undergoing a mercurial course, we 
must keep up his constitution well with good diet, iron, and 
perhaps a little stimulant ; for experience shows that mer- 
cury far more speedily exerts its debilitating influence on 
weak persons or those who are enfeebled by fasting. 



MERCURY. 333 

We must, therefore, beware of its use in consumptive or 
strumous persons, or in those suffering from Bright's disease 
or diabetes, and recollect that idiosyncrasy may here play an 
important part, and that some persons are much more readily 
salivated than others, without known cause. 

Children, more especially those under the age of two 
years, are rarely if ever salivated, and only show the influ- 
ence of the drug by peculiar greenish stools ; but in the for- 
tunately exceptional cases of its occurrence it is too often 
uncontrollable, and is followed by destructive ulceration and 
even gangrene. Another danger pointed out by Mr. Hutch- 
inson is of causing a peculiar malformation of the teeth due 
to the incautious use of gray and other so-called "teething" 
powders in early life. 

Mode of Elimination, etc. 

Mercury is eliminated principally by the urine, but also 
in smaller degree by the saliva and the biliary and intestinal 
secretions. 

Modes of Administration, Dose, etc. 

In the treatment of syphilis, mercury may be given by 
inunction, in which from 5ss to 5j of blue ointment is rubbed 
into the skin once or twice a day, varying the place of appli- 
cation so as to avoid that cutaneous irritation which may 
otherwise result. This method, although very effectual, is 
dirty, and rather liable to cause excessive salivation. 

The oleate of mercury made by dissolving the oxide in 
oleic acid, and varying according to strength from a clear 
solution to a resin-like ointment, is a very clean way of using 
the drug externally, and, in addition to its value in syphilis, 
may be employed in articular inflammation, simple syno- 
vitis, threatening abscess, orchitis, sycosis, etc. (Marshall.) 

Fumigation is also extensively employed, but it is only 
of real service in the cutaneous affections dependent on 
secondary syphilis, where the actual deposition of the vapor- 
ized calomel on the skin produces a beneficial local influence. 
Twenty grains of calomel are used at each sitting, and are 
diffused along with watery vapor by a spirit-lamp, and 
brought in contact with the patient, as he sits covered with 
a blanket, on a perforated chair, over the fumigating appa- 
ratus. 



3o4 



MERCURY, 



Corrosive sublimate has been used by subcutaneous injec- 
tion, but in this way it creates great local irritation ; hard, 
black, painful lumps, often running into abscess, being pro- 
duced at the site of puncture, and although much ingenuity 
has been expended on the search for a harmless solution, no 
success has yet attended these efforts. This, however, 
matters the less, because no reliable evidence has been offered 
to show any advantage in this plan over others, and it is un- 
doubtedly much better to administer it by the mouth, when 
it is specially useful in chronic skin and throat affections. 
Some authorities prefer to give it alone, whereas others advise 
a combination with potassium iodide, thus : — 



S- 



Hydrarg. chlor. corrosiv. 
Potassii iodidi 
Decocti cinch onse 
f §j ter die post cibum. 




gr. ss ; 
3ss ; 
f§viij ; 


or 
" 2 

" 256 


Hydrarg. chlor. corrosiv. 
Acidi muriatici dilnti 
Mellis despumati 
Aqua destillatee q. s. 


ad 


gr. ij ; 
fix; 


or 

" 8 
" 32 
" 320 



03 Gm. 



12 Gm. 



" M. 

An excellent gargle for syphilitic throat ulceration. 

Opinions vary considerably regarding the best form of 
mercury for internal administration in the treatment of sy- 
philis. Mr. Hutchinson prefers hydrarg. cum creta in doses 
of from gr. iij to gr. v, two or three times a day. Ricord, on 
the other hand, advises gr. j-iij of the green iodide [but it is 
ordinarily given in much smaller doses to begin with], whilst 
others are content to employ the pil. hydrarg. in gr. j-iij 
doses in pill, keeping its purgative properties in check by a 
little opium. 

]£. Pil. hydrargyri gr. ij ; or 12 Gm. 

Pulveris opii gr. | ; " 015 " 

Confectionis rosse q. s. " M. 

Ut fiat pilula quarta quaqua hqra sumenda. 

[The following is a good formula for the protiodide : — 



I£. Hydrarg. iodidi viridis, 






Extract, lactucarii, 


aa gr. xlv ; 


or 3 


Extract, opii 


gr. xv ; 


" 1 


Confectionis rosse 


51 ss ; 


" 6 


In pil. no. lx dividenda. 






S. Dose, 1 to 3 pills a day.] 







Gm. 



M- 



In secondary syphilis.'] 






MERCURY. 335 

For purgative purposes the blue pill is generally pre- 
scribed in 5-grain doses, taken overnight, and aided by some 
saline aperient in the morning. 

I£. Hydrarg. clilor. mitis gr. xij ; or [80 Gm. 

Mannae gr. vj ; " 40 " 

Pulveris tragacantliae comp. TBr.] gr. vj ; " J40 " M. 

Divide in pilulas sex. Capiat duas pro re nata. 

A good purgative formula. 

As a diuretic the following is the useful old combination, 
sometimes known as the " Guy's," and sometimes as 
"Baillie's Pill:"— 

$. Pilulse hydrargyri gr. iij ; or 20 Grm. 

Pulveris scillfe gr. jss ; " 10 " 

Pulveris digitalis gr. ss ; " 03 " M. 

Fiat pilnla bis terve die sunienda. 

[Unguentum hydrargyri nitratis (citrine ointment) is much 
used as a stimulant and alterative application in chronic 
skin diseases and ophthalmia. It generally requires to be 
well diluted. 

The decoction of Zittmann may be used with great ad- 
vantage as a gentle diaphoretic and alterative in secondary 
syphilis, either alone or as an adjuvant to mercurials. It 
has been also used with advantage in scrofulous conditions 
of the system, in chronic rheumatism, in skin diseases, and 
obstinate ulcerative affections. The dose is one wine-glassful 
of each strength several times daily. The formula of the 
Prussian Pharmacopoeia is as follows : — 

Decoctum Zittmanni fortius — Take of sarsaparilla root 
cut 100 parts ; digest in water 2600 paits for 24 hours, and 
add, inclosed in a linen bag, powdered sugar and alum, each 
6 parts, calomel 4 parts, and cinnabar 1 part ; then heat in a 
covered vessel placed in a steam-bath for three hours, stirring 
frequently, and, near the end of the boiling, add anise and 
fennel, bruised, each 4 parts, senna, cut, 12 parts, and licorice- 
root, cut, 12 parts. Express, strain, set aside for some time, 
and decant to obtain 2500 parts of the clear liquid ; 2500 
grammes of this are to be divided into 8 parts. 

Decoctum Zittmanni mitius Take the residue left from 

the preceding and 50 parts of sarsaparilla ; heat with water 
2600 parts, for three hours, in a covered vessel placed on a 
steam-bath, stirring frequently, and when near the end of 
the boiling, add le.mon-peel, cinnamon, cassia, cardamom, 



336 HYDRASTIS — HENBANE. 

and licorice-root, each, cut and bruised, 3 parts. Express 
and operate as before, to obtain 2500 parts. 1 

Mercury was detected by Wiggers in this decoction in 
very small proportion. It should not be prepared in metal- 
lic vessels lest the mercurial in solution should be decom- 
posed.] 



[HYDRASTIS— HYDRASTIS. 

The rhizome and rootlets of Hydrastis Canadensis, Linn6 (2V. 0. Ranun- 
culaeece). 

Officinal Preparation, U. S. 

Extraetum Hydrastis Fluidum. Dose, n^v-xxx 
(32. to2Gm.). 

Tinetura Hydrastis (20 per cent.). Dose, 3ss-ij (2 
to 8 Gm.). 

Hydrastis is an indigenous bitter tonic, containing the al- 
kaloids berberine and hydrastine, and is said to have decided 
diuretic properties. A decoction has been used as an injec- 
tion in gonorrhoea. Its exact therapeutic place among reme- 
dies does not appear to be well defined ; but it is claimed to 
be a stomachic tonic, useful in atonic dyspepsia, in chronic 
alcoholism, and in hemorrhoids and some hepatic disorders.] 



HYOSCY^AMUS— HENBANE. 

[ The leaves of Hyoscyamus niger, Linne* (iV. 0. Solanaceoz) , collected 
from plants of the second year's growth. 

Officinal Preparations, U. S. 

Abstraetum Hyoseyami. Dose, gr. i-iij (.06 to 
.20 Gm.). 

Extraetum Hyoseyami Aleoholicum. Dose, gr. 
J to gr. j (.01 to .0(i Gm.). 

Extraetum Hyoseyami Fluidum. Dose, n^v 
(.30 Gm.). 

Tinetura Hyoseyami (15 per cent.). Dose, f5ss— ij 
(2. to 8. Gm.). 

\} The National Dispensatory, Stille and Maisch, Philadelphia, 
1879, p. 497.] 



HENBANE. 337 

Hyoseyaminae Sulphas, Dose, ^-J (.001 to .015 
Gm.j. 

Hyoscyamus is, like belladonna, a hypnotic and mydriatic, 
and owns the same antidotes.] 

The remarks made with reference to stramonium are 
equally applicable to hyoscyamus, which also contains an 
alkaloid, hyoscyamine, probably identical with atropine. The 
main point of difference, then, from belladonna, is the supe- 
rior narcotic powers of hyoscyamus, which have been espe- 
cially prized and developed in lunacy practice. It is also a 
favorite remedy in painful and irritable affections of the 
bladder, where it seems to exert a marked soothing influence, 
and it is an excellent addition to cough mixtures. 

1$. Extracti belladonnas gr. iij ; or 20 Grm. 

Camphorae gr. xij ; " 80 " 

Extracti hyoscyami gr. xv ; '* l| " 

Misce, fiant pilulae sex, quarum sumat imam bora decu- 
bitus. 

Narcotic for nervous insomnia. 

I£. Tincturse hyoscyami tt^xxx ; 

Potassii carbonatis gr. x ; 

Syrupi papaveris [Br.] fgij ; 

Aquas camphorae q. s. ad f^iss; 
Misce, flat baustus bora somni sumendus. 

. Narcotic. 

$. Vini ipecacuanbse f^ij ; 

Ext. hyoscyami fluid. f 5j ; 

Tincturae scillae f |ss ; 

Syrupi tolutani f%] ; 

Aquae carol q. s. ad f §vj ; 

Misce. Capiat semuncium ter quaterve in die. 

Cough mixture. 

Dr. Robert Lawson, late of the West Riding Asylum, has 
made a large variety of very interesting physiological and 
therapeutical observations on the actions and uses of hyos- 
cyamine, the alkaloid of hyoscyamus. He has found that 
it produces "a subdued form of mania, accompanied by al- 
most complete paralysis of the voluntary muscles, and end- 
ing in quiet and refreshing sleep;" and he thinks that this 
might advantageously be substituted for opium in many 
forms of extreme excitement occurring among the insane. 
He has derived great benefit from the drug in "the treat- 
20 



2 


(Jm, 




65 " 


8 


a 


48 


a 


8| Gm. 


4 " 


16 " 


32 1 " 


192 


i< 



338 HENBANE. 

ment of recurrent, acute and subacute mania, and the mon- 
omania of suspicion," and recommends the following for- 
mula: — 

06 Gm. 
50 " 
60 " 



fy. Hyoscyaminse 


gr- J ; 


or 




Sp. setheris [Br.] 1 


TTtviij ; 


ti 




Alcoholis 


TT^xxiv ; 


a 


1 


Aquse fontis 


q. s. ad f §j ; 


tt 


32 


Misce, ut fiat liaustus. 









Ringer records a very interesting case of acute mania in 
which gr. j of hyoscyamine quieted the patient and produced 
sleep, the first dose causing deep flushing of the face and 
hands, with quickening of the pulse. He has found it use- 
less in delirium tremens. Mr. Clifford Gill, of the York 
Asylum, has made many observations on the drug, finding 
that physiologically it causes loquacious rambling, hallucina- 
tion of sight and hearing, drowsiness, hypermetropia, dry- 
ness of mouth, and deficient co-ordination of lower limbs. 
In violent mania it acts well, but as some persons are intole- 
rant of its action, and death has been caused by syncope, we 
must proceed cautiously and begin with small doses (gr. ^~ 
|). The pure alkaloid is quite expensive, but an efficacious 
extract containing the amorphous salt is made by Merck ; 
and Gill recommends a solution of gr. ij to the ^j of ether 
and alcohol, freshly prepared ; as it soon deteriorates, it must 
be kept from the light. It has also been used with some 
success in chorea. 

[According to Gnauck (Centralblatt fur die Med. Wis- 
senschaften, No. 45, 1881) hyoscyamine is composed of 
hyoscine and tropaic acid. From experiments upon healthy 
individuals and others, he concluded that hyoscine is ten 
times stronger than hyoscyamine. Small doses of the iodide 
of hyoscine produce the same symptoms as hyoscyamine ; in 
addition, however, there is a retardation of the pulse even 
with larger doses, varying with the dose and susceptibility of 
the individual. 

Even £^ of a grain invariably produces some of its effects 
in from two to twelve minutes. The fall in the pulse is the 
first symptom to appear, and the last to disappear, the re- 
duction ranging from eight to twenty beats. 

A slight reduction of the pulse also occurs at the beginning 
of the action of atropine and hyoscyamine, and with small 

1 [A solution of ether, one part, to rectified spirit, two parts.] 



ISINGLASS TGNATTA. 339 

doses, but this is quickly followed by paralysis of the ter- 
minal filaments of the vagus. Hyoscine probably causes the 
fall by irritation of their filaments; tropaic acid, therefore, 
having the power to alter its action.] 

[ICHTHYOCOLLA—ISINGLASS. 

The swimming bladder of Acipenser Huso, Linnt, and of other aperies of 
Acipenser (Class Pisces, Order Sturiones). 

Emplastrum Icthyocollae. 

Isinglass is only used in medicine as an article of diet for 
the sick, and as the basis of court-plaster.'] 



[IGNATIA— IGNATIA. 

The seed of Strychnos Ignatii, Bergius (/V. 0. Loganiacece). 
Officinal Preparations, U. S. 

Abstraetum Ignatiae. Dose, gr, \-% (.015 to .03 

Gm.). 

Tinetura Ignatiae (10 percent.), n^ij-x (.13 to .65 
Gm.). 

Is used for the same purpose as Nux Vomica, but is a 
somewhat stronger preparation; the seeds containing about 
one per cent, each of strychnine and of brucine. (See Nux 
Vomica.)] 



[Infusa. 

The officinal Infusions are — 

Infnsum Brayerae (6 per cent.). Infusura Seniiie Compositum 

" Cinchona? (6 per cent.). (sennse 6, manna 12, 

" Digitalis (1£ per cent.). sulphate of magne- 

11 Pruni Virginians (4 sium 12, fennel 2, 

per cent.). boiling water q. s. ad 

100 pts.). 

Note. — An ordinary infusion, the strength of which is not di- 
rected by the physician, nor specified by the Pharmacopoeia, shall 
be prepared by the following formula : The substance, coarsely 
comminuted, 10 parts ; boiling water 100 parts ; water, to make 
100 parts by weight. Put the substance in a suitable vessel, pro- 
vided with a cover, pour upon it the boiling water, cover the vessel 
tightly, and let it stand two hours, then strain and pass enough 
water through the strainer to make the infusion weigh one hundred 
parts.] 



340 ILLICTUM — IODINE 

[ILLICIUM—ILLICIUM (STAR ANISE). 

The fruit of lllicium anisatum (N. 0. Magnoliaeeos). 

Contains a volatile oil corresponding with the tests for oil 
of anise, for which it is substituted (see Anisum)]. 



INULA— INULA. 

[Theroot of Inula Helenium, Linne* (N. 0. Compositce). 

Elecampane contains a large proportion of a peculiar 
starch (Inulin), also a resin, and a bitter crystallizable sub- 
stance, Helenium, with alant camphor. The powdered root, 
gr. xx-5j (1.30 to 4. Gm.), is used in a decoction (^ss to 
Oj) as a diaphoretic and expectorant.] 

IODUM— IODINE. 

[A bluish-gray non-metallic element obtained principally from the ashes of 
sea-weeds. It melts and raises in purple vapor when heated. 

Jn bluish-black crystalline scales having the metallic lustre. Its specific 
gravity i& 4.9. I. = 126.6. 

Officinal Preparations, U. S. 

Tinctura lodi (Iodine 8 per cent.). Dose, n^v-x (.30 
to .65 Gm.). Generally used externally. 

Liquor lodi Compositus (iodine 5 ; potass, iod. 10 ; 
distilled water 85 pis.). LugoPs Solution. Dose, gr. v-x 
(.30 to .65 Gm.). 

Unguentum lodi (Iodine 4 per cent. ; potass, iod. 1 
per cent, in benzoinated lard). 

Liquor Arsenii et Hydrargyri Iodidi (Donovan's 
Solution). Dose, gtt. v-x (.30 to .65 Gm.). 

Syrupus Ferri Iodidi (iodide of iron, 10 per cent.). 
Dose, ttlx-xxx (.65 to 2. Gm.). 

Pilule Ferri Iodidi (each containing gr. j of ferrous 
iodide). 

Amylum Iodatum (starch 95, iodine 5 parts). Dose, 
gr. v-5j (.32 to 4. Gm.). 

Syrupus Aeidi Hydriodici (contains 1 per cent, of 
absolute acid). Dose, 3^-iv (2 to 16 Gm.). 



TODTNE. 341 

Also enters into Sulphuris Iodidum, Argenti Iodidum, 
Arsenii Iodidum, Liquor Arsenii et Hydrargyri Iodidi, 
Hydrargyri Iodidum Rubrum, Hydrargyri Iodidum Viride, 
Plumbi Iodidum, Potassii Iodidum, and Unguentum Potassii 
Iodidi, Ferri Iodidum Saccharatum, Sodii Iodidum, Ammo- 
nii Iodidum, Zinci Iodidum. 

Antidotes. 

Starch and demulcents. For the inconvenience arising in 
some persons very susceptible to iodine (as the severe catar- 
rhal symptoms after taking potassium iodide) a warm bath 
and small doses of deodorized tincture of opium are useful. 

Incompatibles. 

With Iodine Alkalies and alkaloids (quinine and strych- 
nine) ; extracts containing starch ; water precipitates the 
iodine from tinctura iodi. The compound liquor may be 
diluted with water without precipitation. 

With Potassii Iodidum. — Acids, acetate of lead, and the 
metallic salts generally. 

With Ferri Iodidum. — Lime-water, alkalies, and the 
vegetable astringents.] 

Local Actions. 

Physiological. Therapeutical. 

Iodine in substance is It is therefore of some 
never used save for its anti- value for the correction of 
septic properties. Dissolved fetor in drains, etc. 
in spirit, however, it is an The tincture or liniment 
excellent counter-irritant, of iodine is very extensively 
producing itching and smart- used as a counter-irritant 
ing of the skin, with desqua- application to enlarged 
mation of cuticle, and even glands, chronic abscesses, 
blistering if the application swollen joints, chilblains, and 
be too frequently repeated, to various forms of skin 
It has been shown that this disease, more especially the 
local action of iodine is at- common varieties of ring- 
tended by a very free extru- worm, which speedily yield to 
sion of colorless blood-corpus- this treatment. It is very 
cles into the subcutaneous useful when painted over the 
cellular tissue. chest in chronic pneumonia 

29* 



342 



IODINE. 



Experiment has proved 
that iodine is not absorbed 
into the system through the 
unbroken cuticle of adults. 
M. Jules Simon, however, tells 
us that the application to the 
skin of children of equal parts 
of tinct. of iodine and glyee- 
rin will cause on the follow- 
ing day the appearance of 
iodine and albumen in the 
urine. 

Inconvenient results have 
occasionally followed its ab- 
sorption after injection into 
ovarian cysts. 



and fibroid and tubercular 
affections of the lungs; and 
Mr. Jordan, of Birmingham, 
has drawn attention to the 
great success attained by him 
in the dispersion of boils, 
carbuncles, and suppurating 
glands by iodine freely ap- 
plied to a neighboring vas- 
cular area. 

It is also an excellent in- 
jection into various secreting 
cavities, curing hydrocele by 
obliterating the sac of the 
tunica vaginalis, acting well 
on the same principle in some 
rare cases of ovarian dropsy 
and bronchocele, and deodo- 
rizing and lessening dis- 
charges in empyema and sup- 
purating glands. Pledgets of 
iodized wool for the vagina 
will be found useful. 



Constitutional Action. 



Physiological. 

1. On Brain and Nervous 

System No special action on 

the nervous system has been 
observed, unless we hold that 
the uncomfortable sensations 
of misery and depression oc- 
casionally following the use 
of pot. iod. may be thus 
explained, and patients occa- 
sionally complain of weari- 
ness and muscular debility, 
due, no doubt, to the action 
of the potassium on the spinal 
cord. 

2. The effects of iodine on 
the circulation have never 



Therapeutical. 

1. Iodide of potassium is 
of great service in many brain 
diseases, and most especially 
those in connection with ter- 
tiary syphilis, where gummata 
and other forms of tumor 
cause those excruciating pains 
and varying nervous pheno- 
mena which have been so ably 
described by Drs. Broadbent 
and Buzzard. 



2. Pot. iod. has been used 
with great benefit by Dr. 



IODINE. 



343 



been properly estimated, but 
some observers say that it 
tends to contract the vessels 
and eause increased rapidity 
of the heart's action. Pot. 
iod. has very swift diffusive 
power, entering the blood 
very rapidly, and being given 
off within ten minutes after 
ingestion. 

3. On respiration and tem- 
perature no effects have been 
noted. 

4. Effects on secretion. 

i. Intestinal. — Nothing spe- 
cial save occasional loss 
of appetite and disor- 
dered digestion. 

ii. Urinary Pot. iod. has 

some diuretic action, 
more especially in con- 
nection with other drugs, 

iii. The salivary secretion is 
often markedly increas- 
ed, true salivatton being 
sometimes produced. 

iv. It is also believed that 
pot. iod. has some special 
action on glandular tis- 
sues in general, increas- 
ing their absorptive 
powers, and even excit- 
ing them to absorb them- 
selves; and in support 
of this last proposition it 
has been stated that, 
under its use, the mam- 
mre and testicles have 
been observed to waste 
and disappear. This 
conclusion has evidently 
been arrived at, however, 
by confusing the post 



Balfour and others in aortic 
aneurism, several successful 
cases having been reported. 
It is difficult to explain the 
rationale of its action, but it 
is essential that large doses 
(twenty grains) be prescribed 
and continued regularly for a 
year or more. 



ii. Pot. iod. is occasionally 
used to heighten the 
diuretic action of other 
drugs. 



v. Pot. iod. is often given to 
facilitate and hasten the 
absorption of the pro- 
ducts of inflammation in 
the later stages of pleu- 
risy, pneumonia, peri- 
carditis, etc. 
It is probable that in pre- 
sence of the ozone and 
acids of the blood free 
iodine is set free, which 
then acts on those albu- 
minoid substances for 
which it has an affinity. 



344 



IODINE. 



with the propter hoc, 
and it is probable that 
the remedy does not so 
much actually stimulate 
the absorbents as reduce 
effused lymph to a con- 
dition more favorable for 
elimination, 
o. It also has the power 
of removing various metallic 
substances from the tissues, 
mercury and lead, for in- 
stance, being occasionally de- 
posited in the form of an 
insoluble albuminate, and re- 
leased from this condition by 
the action of the drug. 



6. Finally pot. iod. has an 
irritating action on mucous 
membranes, causing redness, 
tingling, and free secretion, 
much resembling an ordinary 
catarrh, and also thinning 
and liquefying tenacious pa- 
thological mucoid secretions. 

7. There are other import- 
ant uses of pot. iod. which 
cannot be arranged under the 
preceding categories, and 
which must therefore, if we 
admit the use of such a word, 
be called specific. These are 
its influence over syphilis, 
gout, chronic rheumatism, 
and simple periostitis. 

In the somewhat myste- 
rious language of old-fash- 
ioned therapeutics, potassic 



5. In chronic lead-poison- 
ing, so often met in house- 
painters, and to remov« mer- 
cury from the system, we 
generally prescribe pot. iod., 
and in the latter case we 
must not be surprised if our 
patient is suddenly seized 
with profuse salivation. This 
is explained by the released 
mercury finding its way back 
into the circulation, and ex- 
erting its usual influence on 
the salivary glands. 

6. Pot. iod. is often pre- 
scribed in cases of bronchitis 
where the expectoration is 
thick, tenacious, and difficult 
of expulsion, and it here acts 
well by thinning the sputa. 



7. In cases of tertiary sy- 
philis pot. iod. often acts like 
a charm. In the primary 
and secondary forms it is of 
little or no use, but when the 
deeper tissues begin to be 
affected, and when we meet 
with deep rupial or other 
ulcerations of the skin, ulcers 
in the throat, periostitis, and 
head symptoms, we may then 
prescribe iodine with the 
certain expectation of relief. 



IODINE. 345 

iodide has also been known In chronic gout it is also of 
as an " alterative." service, and in chronic rheu- 

matism, more especially in 
those cases where we meet 
with tenderness to pressure 
and nocturnal increase of 
pain. In simple periostitis 
of the head, sternum, or tibia, 
which often results from ex- 
posure to cold, pot. iod. has 
an almost magical effect, and 
will often bring about a cure 
after two or three days' treat- 
ment. 

Pot. iod. is eliminated from the body by the urine, saliva, 
tears, milk, etc. ; it is rapidly absorbed, experiment having 
shown that water containing a minute quantity of the salt 
has its diffusive power greatly increased. It can be detected 
in the urine in ten minutes after being swallowed, and is 
rapidly given out, so that the whole may be recovered from 
the various secretions. 

Disadvantages and Contra-indications. 

As regards its disadvantages and contra-indications we 
must remember the possible occurrence of iodism, to which 
unpleasant symptoms some persons are much more suscep- 
tible than others. These consist, in the first place, of irri- 
tation about the mucous membranes, running at the eyes and 
nose, sneezing, frontal headache, swelling of the eyes, and 
salivation ; an eruption not unlike nettle-rash is sometimes 
observed ; occasionally acne may be the result, and Ringer 
has described a peculiar petechial eruption affecting the legs, 
Quite recently Mr. J. Hutchinson has expressed his belief 
that the formidable pustular eruption known as hydroa is 
really caused by iodide of potassium ; but in my own experi- 
ence and that of others who. have freely prescribed the drug, 
these various uncomfortable effects are comparatively seldom 
observed, a curious point being that iodism seems to be much 
more readily excited by small than by large doses of the 
drug. 

In some persons a good deal of depression and digestive 
derangement is caused, with nausea, diarrhoea, and debility, 



346 IODINE. 

and troublesome pains in the joints. It is badly borne in 
exophthalmic goitre, causing rapid emaciation. 

A variety of eruptions have been described, all of which 
are more likely to occur in patients suffering from kidney 
disease : — 

1. A rash resembling urticaria has been observed. 

2. An eruption which probably, according to its various 
stages, may be vesicular, papular, or pustular, closely resem- 
bling acne, or a more formidable condition of things may 
arise from its development into bullae, which occasionally 
bursting may form fungoid masses, varying in size from a 
pea to a shilling. This is held to differ from hydroa, which 
Mr. Hutchinson tells us is almost invariably due to iodide of 
potassium. 

3. Small round miliary discrete petechial spots on the 
front of the leg, below the knee, occurring from two to six 
days after the moderate use of the drug. 

4. A general eruption of purpura. Dr. Stephen Mackenzie 
records a fatal case in a child of five months, following a 
single 2|-grain dose. 

5. A tendency to erysipelas has been noted in patients 
taking potassic iodide. 

It is fortunate for the credit of one of our most useful 
drugs that these eruptions are rarely observed, the most com- 
mon being a few acneiform pustules on the face, which care- 
ful microscopic observations have proved to be quite uncon- 
nected with the sweat-glands, but to depend on plugging of 
the small vessels with coagula, followed by rupture and ex- 
trusion of their contents. 

Antidote. 

Some few years ago Sir James Paget observed that the 
addition of sp. am. aromat. to pot. iod. not only lessened the 
chances of iodism, but enabled us to limit ourselves to a 
smaller dose, and this has come very generally into use. 
Seguin tells us that we can usually avoid iodism if we give 
pot. iod. in free dilution on an empty stomach, about half an 
hour before a meal. He points out that, if given on a full 
stomach, the acid reaction of the half-digested food splits up 
the salt and liberates free iodine. 






IODINE. 34*7 



Dose and Mode of Administration. 

Tinctura iodi 5 to 20 minims, but this is seldom prescribed 
internally. 

Pot. iod. as anti-syphilitic, from 3 to 30 grains, or even 
60, according to the judgment of prescribers, it being neces- 
sary in obstinate cases to push the drug very freely. 

Professor Syme, however, used to say that all good effects 
can be obtained by two or three grains, and in ordinary cases 
of syphilis or periostitis, rheumatism, etc., this will be found 
a sufficient dose, copious dilution aiding its effects. 

In aneurism we must give at least twenty grains, and in 
advanced syphilitic affections even larger doses are well 
borne. 

1$. Potassii iodidi gr. xl ; or 2 60 Gm. 

Spiritus ammoiiise aromatici f.^ss ; " 16 

Syrupi aurantii fjj ; " 32 

Decocti sarsae cornpositi ad f^viij ; " 256 

Capiat uuciaui unani ter in die. 

Coster's paste, or iodine dissolved in colorless oil of tar, is 
a useful application in ringivorm. 

R. Iodi 5ij. 

01. picis liq. ad gj. M. 
(The colorless oil of tar.) 

It is sometimes convenient to decolorize iodine, and this 
may be done by carbolic acid, or by adding forty minims of 
a saturated solution of hyposulphite of sodium to each ounce 
of the tincture. 

Linimentum potassii iodi cum sapone P. B. is an excel- 
lent preparation, verj useful in chronic rheumatism and en- 
largement of the joints. 

[Hydriodic acid is a recent addition to our means of ad- 
ministering iodine for obtaining the constitutional effects, 
and it has been used with success in asthma, bronchitis, and 
hay fever. It is prepared on a small scale by the action of 
hydrogen sulphide on iodine mixed with water. It is, when 
pure, a colorless, irrespirable, and uninflammable gas, resem- 
bling somewhat in odor hydrochloric acid. Dissolved in 
water, it forms a clear, limpid solution, with an acid reac- 
tion, and rather a pungent, styptic taste ; but quickly de- 
composes upon exposure to the air, the solution becoming 
colored by free iodine. It may be obtained, however, in a 



348 IODOFORM. 

stable form as a syrup. The syrup of hydriodic acid Is of a 
light-straw color, free from smell, with a sweet, styptic, 
though not disagreeable, taste. The dose usually ordered is 
from one to three drachms in water, several times a day.] 



[IODOFORMUM— IODOFORM. 

In yellow, scaly crystals having the odor of saffron. It is insoluble in ivater, 
but soluble in alcohol, ether, and the fixed and volatile oils. By a heat 
above 25(P it is decomposed, giving off' violet vapors. 
(CHI 3 ; 392.8.) 

Unguentum Iodoformi (10 percent.). 

It is prepared by decomposing an alcoholic solution of 
iodide of potassium witli lime. As a local anaesthetic, it is 
applied in powder to painful ulcers, whether chronic, can- 
cerous, or syphilitic, where it relieves pain and promotes 
cicatrization. Suppositories (gr. v-x) are used in hemor- 
rhoids and uterine cancer. In ethereal solution (20 per 
cent.), it has been highly recommended as an application in 
chronic inflammoMon of the throat. 1 Its abominable odor 
almost precludes its use outside of the hospital wards.] 

Iodoform is not much used internally, on account of its 
disagreeable taste and tendency to produce iodism. 

Experiments on animals have shown that it produces fatty 
degeneration of the heart, liver, and kidneys, and death with 
symptoms of general paralysis. 

It is, however, an excellent local application, being anaes- 
thetic in its properties, although its first application causes 
smarting. 

When applied to the surface of the body, dissolved in col- 
lodion, it reduces the temperature. 

It is an admirable application to venereal sores, chronic 
ulceration of every kind, including diphtheria and cancer, 
rupial sores, bubos, and indolent sinuses, throat ulcerations, 
ozaena, subacute eczema, and post-nasal catarrh, catarrhal 
inflammation of the tympanum and Eustachian tube, and 
purulent conjunctivitis. 

It may be used in powder, as an ointment with vaseline 
(1 to 4), the odor being concealed by some aromatic oil, 

i (Phil. Med. Times, vol. iv. p. 4, 1873.) 



IPECAC. 



349 



and especially balsam of Peru and musk, dissolved in chloro- 
form, which is its best solvent ; or as iodoformed wool. 



fy. Iodoformi 


gr. i; 


or 


JO. 6 Gm. 


Balsami Peruviani 


gr. ii ; 


(< 


13 " 


Petrolati 


gr. viii ; 


<( 


50 " M 


Fiat unguentum. 









IPECACUANHA— IPECAC. 

[ The root of Cephaelis Ipecacuanha, A. Richard (N. 0. Rubiaceai 
Coffece). 

Officinal Preparations. 

Extractum Ipeeaeuanhae Fluidum. Dose, gtt. 
xxx (2. Gm.). 

Pulvis Ipecacuanhas et Opii. Dover's powder 
(Ipecac, gr. j; opium gr. j ; sulph. potass, gr. viij). Dose, 
gr. x (.65 Gm.). 

Trochisei Ipeeaeuanhae (gr. \ in each). 

Trochisei Morphinae et Ipeeaeuanhae (Mor- 
phine gr. ¥ V ; ipecac, gr. T \). 

Syrupus Ipecacuanhas (Extract f^ij to syrup xxx). 
Dose, f5ij-fgss (2 to 16. Gm.). 

Vinum Ipeeaeuanhae (f|ij extract to sherry wine 
f^xxx). Dose, f'5j-iv (4. to 16. Gm.).] 



Local 

Physiological. 

The prolonged application 
of ipecacuanha to the skin 
causes some irritation, fol- 
lowed by the appearance of 
vesicles, pustules, and even 
troublesome ulceration. In 
some persons the powdered 
root causes violent irritation 
of the respiratory passages, 
ranging from symptoms re- 
sembling hay-fever up to a 
spasmodic condition analo- 
gous to true asthma. 

30 



Actions. 

Tlier apeuticaL 

The use of the slowly act- 
ing and pustulating forms of 
counter-irritation has fallen 
out of fashion, as they are 
not only disfiguring, but give 
less relief than more sedative 
applications. 

The only way in which we 
find ipecacuanha employed 
locally is in the form of 
spray, which Prof. Pinger 
has found very useful in 
chronic bronchitis, winter 
cough, bronchial asthma, 



350 



IPECAC. 



with emphysema and fibroid 
phthisis. As the pure wine 
may cause nausea and irrita- 
tion, he devises a dilution 
with from one to two parts of 
water, using the ordinary 
s pray- producer, beginning 
with about twenty squeezes 
for the first sitting, once a 
day, but afterwards more fre- 
quently repeated, the mouth 
being well rinsed out after 
each application. Cases of 
winter cough were generally 
cured in twelve days. 



1. Brain 
System — 1. No effect seems 
to be produced on the brain. 

2. Ipecacuanha has a mark- 
edly stimulating influence on 
that centre in the medulla ob- 
longata which presides over 
the action of vomiting. It 
has been found, by experi- 
ment, to cause diminution of 
tactile sensibility and paraly- 
sis of the arms or fore-legs, 
not unlike glossopharyngeal 
paralysis, and probably de- 
pending upon exhaustion of 
the medulla by the vomiting 
act. Whether by subcutane- 
ous injection, or by being 
taken into the stomach, it 
causes, within a moderate pe- 
riod, a decided but mild em- 
etic effect ; and as this may 
arise either from irritation of 
the mucous membrane of the 
stomach, or from a primary 



Constitutional Actions. 
and Nervous 



2. Ipecacuanha cannot be 
recommended in cases of 
poisoning, for not only does 
it act too slowly, but its nau- 
seating and depressing influ- 
ence may be injurious. It 
is of great service, however, 
in many of those affections 
of the throat or respiratory 
organs where we wish to 
empty the lungs or detach 
foreign bodies or false mem- 
branes from the larynx or 
trachea, as in bronchitis, 
croup, diphtheria, etc. 

A most remarkable fact in 
the action of this drug is its 
power, when given in small 
doses, of checking vomiting. 
Thus, in the vomiting of 
pregnancy, suckling, or men- 
struation ; in the iritability 



IPECAC. 



351 



stimulation of the vomiting 
centre itself, ipecacuanha 
must be ranked among both 
the direct and the indirect 
emetics. 

Emetine given by subcu- 
taneous injection is much 
slower in its action, and re- 
quires to be given in larger 
doses than by the mouth, 
which proves that it must 
primarily act on the gastric 
mucous membrane. 

It may be said generally to 
occupy a middle place be- 
tween sulphate of zinc and 
tartar emetic, being neither 
so prompt as the first, nor so 
nauseating as the second. 

II. Circulation — Ipecacu- 
anha has no direct influence 
on the heart or circulation, 
save the usual depression fol- 
lowing nausea and vomiting. 
Emetine acts almost like am- 
monia in dissolving the red 
corpuscles of the blood. 

III. Respiration and Tem- 
perature No effect is pro- 
duced on the rapidity of the 
respiratory function, save the 
temporary acceleration usu- 
ally accompanying the act of 
vomiting. There seems no 
doubt, however, that ipeca- 
cuanha causes an increased 
secretion from the mucous 
membrane of the bronchial 
tubes. After poisoning by 
ipecacuanha, the lungs have 
generally been found in a 
bloodless condition in the 
early stages, intense conges- 



of stomach of children, and 
in other dyspeptic conditions 
in which nausea or vomiting 
is a prominent symptom, a 
drop of ipecacuanha wine, 
taken every hour, will often 
prove truly curative. At 
present this must be looked 
upon as one of the enigmas 
of therapeutics. 



III. Ipecacuanha is there- 
fore a most useful expecto- 
rant, thinning and diluting 
the pulmonary mucus, and 
thus facilitating its expulsion. 
It is hence almost universally 
employed in bronchitis, com- 
mon catarrh, winter cough, 
etc. It was formerly used, 
and with some alleged suc- 
cess, in hcemoptysis, 5-grain 
doses repeated at short in- 
tervals exerting a marked 
depressing effect, and thus 
checking the tendency to 
bleeding; but with the intro- 



352 



IPECAC. 



tion following its more pro- 
longed action. 



IV. Digestive and Secret- 
ing Organs — 1 Stomach 

and Intestines As already- 
noted, ipecacuanha causes 
some irritation of the termi- 
nal filaments of the pneu mo- 
gastric nerve distributed to 
the stomach, and thus sets 
in motion the reflex machin- 
ery necessary to produce vo- 
miting. On the mucous lin- 
ing of the intestinal canal, 
also, its effects are undoubted, 
as indicated by its action in 
disease ; but we are at pre- 
sent unable to give any sat- 
isfactory explanation of its 
often marvellous influence 
over dysentery in its various 
forms. 



duction of more effectual re- 
medies, this mode of treat- 
ment has now fallen into dis- 
use. 

IV. 1. Ipecacuanha in 
emetic dose is indicated in 
some overloaded conditions 
of the stomach, caused by 
excessive indulgence either 
in food or drink ; and the 
dull aspect, coated tongue, 
foul breath, headache, and 
nausea, may be promptly re- 
lieved in this way. 

In acute dysentery, ipeca- 
cuanha is now looked upon as 
a never-failing specific. It 
must here be taken in full 
doses, from sixty to ninety 
grains being given at once, 
this vigorous medication often 
cutting short the disease. 

Let the patient remain 
very quietly on his back for 
at least 10 or 12 hours before 
repeating the dose, and even 
then we must be guided by 
symptoms. Although the 
first dose may be rejected by 
the stomach, toleration is 
speedily established, and no 
more vomiting is produced. 
Some authorities recommend 
a previous administration of 
laudanum to quiet the stom- 
ach. [The same treatment 
has been found advantageous 
in the purging of cholera 
morbus.'] 

Under this treatment the 
pain and tenesmus rapidly 



natural color and consistence, 



IPECAC. 



353 



2. Liver. — Ipecacuanha 
is a powerful hepatic stimu- 
lant. It increases slightly 
the secretion of intestinal 
mucus, but has no other 
apparently stimulating in- 
fluence on the intestines. The 
bile secreted under its influ- 
ence has the normal compo- 
sition. (Rutherford.) 

3. Skin. — Ipecacuanha 
promotes slightly the cuta- 
neous secretion, independent- 
ly of the tendency to perspira- 
tion usually attending the ac- 
tion of emetics. 



and the patient makes a satis- 
factory recovery. 

In cases of dysenteric diar- 
rhoea so often met with in 
this country, and more espe- 
cially in children, ipecacu- 
anha in much smaller doses 
is also a very effectual rem- 
edy, the indications for its 
use being any appearance of 
blood or mucus in the stools, 
with pain and straining. In 
the more ordinary forms of 
diarrhoea, however, it is quite 
useless. 

2. It has therefore been 
given in the form of pill, and 
combined with other* reme- 
dies, to relieve the sluggish 
digestion caused by a defi- 
ciency of bile. 



3. Ipecacuanha combined 
with opium, in the form of 
" Dover's Powder," is a well- 
known and tolerably effectual 
diaphoretic, much used in 
chronic rheumatism and fev- 
erish attacks. 



Mode of Elimination, etc. 

It is probable that as much of the ipecacuanha as remains 
after the action of vomiting is eliminated from the system 
by the biliary and intestinal secretions. 

Mode of Administration. 

The action of ipecacuanha wine is so notoriously uncer- 
tain, that, when we wish to obtain the full emetic effect of 
the drug, it is best to have recourse to the freshly powdered 

30* 



354 



JALAP. 



root (15 to 30 grains, or l.to 2. Gm.), remembering, however, 
that children will bear unusually large doses. 

In the treatment of dysentery, also, we shall derive most 
advantage from the use of the powder ; and in ordinary cases 
of dysenteric diarrhoea we may give from ^ to 2 or 3 grains 
in combination with compound tragacanth powder. (P. Br.) 

Vinum ipecacuanhas, in doses of from n^x to 5j> is an 
almost invariable ingredient of cough mixtures. 

[Emetine, the alkaloid of ipecacuanha, is not officinal, but 
is an efficient emetic in doses of gr. T x ¥ to ^ (.005 to 
.01 Gm.).] 



JALAPA— JALAP. 

[The tuberous root of Exogonium purga, Bentham (N. O.Convolvulacece). 

Dose, in substance, gr. x-xxx (.60 to 2. Gm.). 

Officinal Preparations, U. S. 

Abstraetum Jalapae. Dose, gr. v-x (.30 to .65 Gm.). 
Pulvis Jalapae Compositus (jalap 35 parts, cream 
of tartar 65 pts.). Dose, gr. xx-3j (1.30 to 4. Gm.). 
Resina Jalapae. Dose, gr. ij-iv (.12 to .25 Gm.).] 



Physiological Action. 

The action of jalap resem- 
bles that of scammony, only 
differing in being less irri- 
tant and more effectual in 
promoting the flow of watery 
fluids from the bowels. 

Rutherford points out that 
it is a " moderately powerful 
hepatic, and a powerful intes- 
tinal stimulant." 



Therapeutical Action. 

Jalap is undoubtedly one 
of our best hydragogue ca- 
thartics, and is much used in 
cerebral lesions, in kidney 
disease, where the excretion 
of effete products threatens 
to become suspended, and 
when dropsy is setting in ; 
in such cases smart purgation 
by pulv. jalap, co. will often 
produce striking benefit. 

In cardiac disease, also, 
when the right side of the 
heart is engorged by emphy- 
sema or bronchitis, free ca- 
tharsis will unload the dis- 
tended and laboring organ, 
and relieve the condition of 



BUTTERNUT — JUNIPER. 355 

intense dyspnoea, with the 
cold and livid surface and 
indications of approaching 
death. Jalap also acts well 
as an ordinary or habitual 
purgative, and is generally 
prescribed in the form of the 
compound powder, containing 
cream of tartar and ginger. 

[The abstract of jalap is one of the constituents of the 
officinal compound cathartic pill.] 



[JUGLANS— BUTTERNUT. 

The inner bark of the root of Juglans cinerea, Linne (xV. 0. Juglandacece), 
collected in autumn. 

Officinal Preparation, U. S. 

Extractum Juglandis. Dose, as a laxative, gr. v-x; 
as a purgative, gr. xx-xxx (.30 to 2. Gm.). 

Juglans is an indigenous cathartic resembling rhubarb in 
its property of evacuating without debilitating the bowels. 
Mild and efficient in its action, it is well adapted to habitual 
constipation. It may be given in decoction, or in the form 
of the officinal extract.] 



JUNIPERUS— JUNIPER, 

[ The fruit of Juniperus communis. 

Officinal Preparations, U. S. 

Oleum Juniperi. Dose gtt. v-xv (.30 to 1. Gm.). 

Spiritus Juniperi Compositus (Oil of juniper 10, 
oil of caraway and fennel of eacli 1, alcohol 3000, water 
q. s. ad 5000 parts). Dose, f3ij-iv (8. to 16. Gm.). 

Spiritus Juniperi (oil 3 per cent.). Dose, f3ss-j (2. 
to 4. Gm.).] 

Physiological Action. Therapeutical Action. 

Juniper stimulates the ac- Juniper is a good diuretic, 
tion of the kidneys, but, like generally used in combina- 



356 



KAMALA. 



many other remedies of its tion with other drugs, and 
class, only increases the flow acting either when swallowed, 
of urine where dropsy exists, or inhaled in the form of 
It has been shown that in a vapor, 
healthy man the quantity of 
the urine is actually dimin- 
ished, whilst the urea is in- 
creased. 

[When an overdose is 
given, even strangury and 
total suppression may result. 
In small doses it is a gentle 
stimulant and stomachic] 

[Gin, made by steeping juniper berries in spirits, is not 
officinal, but the Compound Spirits of Juniper may be consid- 
ered as its equivalent. Commercial gin is said to sometimes 
contain oil of turpentine.] 



I£ Spiritus juniperi 
Potassii acetatis 
Spiritus setheris nitrosi 
Decocti scoparii [Br.] 

S. Dose, f^j ter die. 

Diuretic mixture. 



fgss; 


or 


16 


^iss ; 


(i 


6 


fij; 


a 


32 


f3 vii J 


(i 


256 



Gm. 



M. 



KAMALA— KAMALA (ROTTLERA, U. S. P. 1870). 

[ The glands and hairs from the capsules of Mallotus philipjnnensis, 
Mueller Arg. (N. 0. Euphorbiacece). 

Dose, 5j-iij (4. to 12. Gm.).] 



Effects. 



Physiological. 

Kamala is a vermicide, 
killing the tape-worm rapidly; 
it also possesses purgative 
properties. 



Therapeutical. 

Kamala is an efficient an- 
thelmintic, differing from 
other remedies of the class 
in its cathartic action. 



KINO — KRAMERIA. 357 

KINO— KINO. 

[ The inspissated juice of Pterocarpus Marsupium, Roxburgh 
(iV. 0. Leguminosce, Papilionacece) . 

Officinal Preparation. 
Tinetura Kino. Dose, f3j-ij (4. to 8. Gm.).] 

Physiological Action. Therapeutical Action. 

Kino is astringent in vir- It may therefore be used 
tue of the tannin which it in diarrhoea and other cases 
contains. where astringents are indi- 

cated, but it seems to have 
no special advantage over 
other remedies of the same 
class. 



KRAMERIA— KRAMERIA (RHATANY). 

[ T he root of Kramer ia triandra, Ruiz et Pavon, and of Krameria Tomen- 
tosa, St. Hilaire (N. 0. Polygalaceai, Kramerieoz). 

Dose in substance, gr. v-xx (.32 to 1.30 Gm.). 

Officinal Preparations, U. S. 

Extractum Krameria^. Dose, gr. v-x (.30 to .65 
Gm.). 

Troehisei Krameria^ (each 1 grain of extract). 

Extractum Krameria^ Fluidum. Dose, gtt. xx 
(1.30 Gm.). 

Syrupus Krameria^ (35 per cent.). Dose, 3j-i y (4- 
to 15. Gm.). 

Tinetura Krameria^ (20 percent.). Dose, f5j-ij (4. 
to 8. Gm.).] 

Physiological Action. Therapeutical Action. 

Krameria has powerful as- Rhatany has been used 

tringent properties, due, no with success in dysentery and 

doubt, to the tannin which it diarrhoea, but is probably 

contains. [It is also gently inferior to many other rerae- 

tonic, and is much esteemed dies of the same class, and 



358 LACTUCARIUM — LAVENDER. 

iii Peru in treatment of bowel is therefore but seldom em- 
affections.] ployed. [It is frequently 

added to chalk mixture, in 
the treatment of diarrhoea of 
relaxation.] 



[LACTUCARIUM—LACTUCARIUM. 

The concrete milk juice of Lactuca Virosa, Linne (N. 0. Composite). 
Dose, gr. xx (1.30 Gm.). 

Officinal Preparations, U. S. 

Extractum Laetucarii Fluidum. Dose,rti,x-xxx 
(0.65 to 2. Gm.). 

Syrupus Laetucarii (5 per cent.). Dose, fgi-iii 
(4. to 12. Gm.). 

Lactucarium, or Lettuce-opium, is a feeble narcotic, and 
is considered slightly laxative and diuretic. It has been 
used as a substitute for the other narcotics in phthisis and 
in diseases of children.] 



LAPPA— LAPPA (BURDOCK). 

[The root of lappa officinalis (2V. 0. Compositce). 
Dose, 5j-iv (.4 to .8 Gm.). 

Burdock root contains a bitter principle, with a little tan- 
nin and volatile oil. The fluid extract or decoction has been 
used in chronic rheumatism, skin diseases, dyspepsia, etc.] 



[LAVANDULA— LAVENDER. 

The flowers of Lavandula vera, De Candolle (N. 0. Labiatce). 

Officinal Preparations, U. S. 

Oleum Lavandulae. Dose, gtt. iij-x(.20 to .60 Gm.). 

Spiritus Lavandulae. Dose, f5ss-j (2. to 4. Gm.). 
Enters into Mistura Ferri Composita. 

Tinetura Lavandulae Composita. Dose, 3*s-j 
(2. to 4. Gm.). 

Oleum Lavandulae Florum (from fresh lavender). 



LEPTANDRA — LEMON JUICE. 359 

Spiritus Odoratus. Cologne water, for external use 
as a perfume. 

Vinum Aromatieum (see page 95). 

Lavender is a carminative, but is rarely used except in 
combination. The compound tincture is its most elegant pre- 
paration, and is a very agreeable stomachic and cordial. 
The oil is used in perfumery. It enters into the officinal Liq. 
Potassii Arsenitis, and Spiritus Ammonite Ammoniaticus.] 



LEPTANDRA— LEPTANDRA. 

[ The rhizome and rootlets of Leptandra Virginica, Nuttall 
{Veronica Virginica, Linne), (JV. 0. Scrophulariaceoz) . 

Officinal Preparations. 

Extractum Leptandrae. Dose, gtt. iij-x (0.20 to 
0.65 Gm.). 

Extractum Leptandrae Fluidum. Dose, 5ss-j (2. 
to 4. Gm.). 

Culver's root is emetic and cathartic, and is also consid- 
ered cholago^ue. Dose of the powdered root, gr. xx to 3j 
(1.32 to 4. Gm.). In small doses (gr. ij— v, or .12 to .30 
Gm.) it is said to resemble rhubarb. The fluid extract 
is aperient in doses of nrx to f'5j (.60 to 4. Gm.).] 



LIMONES— LEMON. 

[ The rind of the recent fruit of Citrus Limonum, Risso (N. O. 
Aurantiaceoz) . 



LIMONIS SUCCUS— LEMON JUICE. 

\_T he freshly expressed juice of the ripe fruit of Citrus Limonum, 
Risso (X. O. Aurantiacetz) . 

Officinal Preparations, U. S. 

Oleum Limonis. 

Spiritus Limonis. Used for flavoring purposes. 
Mistura Potassii Citratis. Neutral mixture. Dose, 
fjss-ij (16. to 64. Gm.). 

Syrupus Limonis. As a vehicle. 



360 LEMON JUICE. 

Spiritus Ammoniae Aromatieus. Dose, f3ss-j 
(2. to 4. Gm.). 
Syrupus Aeidi Citriei. As a vehicle.] 

Constitutional Action. 

Lemon-peel is in some measure tonic and anti-spasmodic, 
and is a useful flavoring ingredient, but lemon-juice has some 
important properties which are purely therapeutical, and 
cannot be explained by any action which it possesses over 
the healthy organism. 

In the first place we must rank its antiscorbutic virtues, 
acting as it does both by preventing and by curing the dis- 
ease, and by its universal use afloat nearly stamping out the 
ravages of what used to be an almost invariable attendant on 
long voyages at sea. The occurrence of scurvy to any ex- 
tent on board ship is now looked upon as a clear indication 
that the regular administration of lime or lemon -juice has 
been neglected, and that the crew has been attacked by a 
painful and dangerous disease, the absolute preventability of 
which experience has amply confirmed. Various explana- 
tions have been given of the cause of scurvy, and there is no 
doubt that it is usually associated with an absence of fresh 
meat and vegetables from the diet scale. Dr. Garrod, how- 
ever, goes further, and teaches that the essence of the dis- 
ease lies in a deficiency of the potash salts ; whilst Mr. 
Morgan, of Dublin, is no less convinced that the absence of 
phosphoric acid is the real cause — both agreeing in this, 
however, that the presence of this special ingredient in 
lemon-juice explains its superiority over citricacid, which is 
in no degree an antiscorbutic. It is unfortunate that lime- 
juice is bulky, and liable to become solid at low tempera- 
tures, and must be also administered in such considerable 
doses as to give some excuse for its occasional neglect on 
expeditions where every ounce of extra weight entails in- 
creased toil and danger. It is to be hoped that some more 
convenient and portable means of using this invaluable drug 
may yet be introduced. 

Lemon-juice was formerly vaunted as a specific for acute 
rheumatism, and although this has not been confirmed by 
experience, there is no doubt that persons afflicted with 
chronic rheumatic pains may often derive benefit from 
taking a tablespoonful of this agreeable remedy two or three 



LINIMENTS — FLAXSEED. 361 

times a day with their meals. Lemon-juice has also been 
called a refrigerant, but its sole claim to this title rests upon 
the great facility with which we may construct refreshing 
effervescing draughts by its aid. Quite recently, however, 
some good authorities have praised it highly as an antipyretic 
in ague, given as a decoction of the freshly plucked fruit. 
[See Citric Acid, page 113.] 



[Linimenta. 

The officinal Liniments are — 

Linimentum Atnraonise Linimentum Chloroformi 

" Belladonna " Plumbi Subacetatis 

" Calcis " Saponis 

" C amphorae " Sin apis Compositum 

" Cantharidis " Terebinthinse.] 



LINUM—FLAXSEED (LINSEED). 

[The seed of Linum usitatissimum (N. 0. Linacece). 
Oleum Lini. Flaxseed oil (Linseed oil). Ext. use.] 

Local Action. 

Physiological. Therapeutical. 

Linseed meal, in the form A linseed poultice is a very 
of poultice, is the most con- soothing and effectual appli- 
venient and effectual way of cation in all acute affections 
applying continuous, moist of the lungs. Not only does 
warmth to the surface of the it relieve pain, but it keeps 
body. Thus used, it relieves up a warm equable tempera- 
pain, relaxes spasm, and is ture and rests the affected 
generally soothing and agree- organ by restricting in some 
able to the feelings of the pa- degree the movements of the 
tient. By relaxing the super- chest walls. It may also be 
ficial vessels, a poultice may used with advantage in peri- 
be in some measure antiphlo- tonitis, in colic, in various in- 
gistic, and may also relieve flammatory affections of the 
the congestion of internal or- throat, and in boils, abscesses, 
gans by drawing blood to the etc., where, if it does not suc- 
cutaneous surface and pro- ceed in arresting the suppu- 
moting perspiration there. rative process, as occasionally 
31 



0b2 FLAXSEED. 

happens, it facilitates and 
hastens the breaking down of 
inflammatory products into 
pus, and thus encourages the 
process of ripening. After 
the opening of the abscess, 
poultices cannot be recom- 
mended, as they are nauseous 
and dirty, and we would much 
rather advise the case to be 
treated on the antiseptic prin- 
ciples of Mr. Lister. 

Linseed oil is an old-fash- 
ioned treatment for burns, 
and, combined with lime- 
water, was formerly exten- 
sively used under the name 
of Carron oil. 

Internal Use. 

An infusion of linseed is Under the name of linseed 

rather soothing in character, tea, this infusion is much 

probably owing to the muci- used in domestic medicine as 

lage which it contains. a soothing remedy for coughs. 

Mode of Administration. 

When used as an application in pleurisy or pneumonia, a 
poultice must extend fairly round the chest ; it should be 
about a quarter of an inch thick, and must be changed not 
seldomer than every two hours, as it soon tends to become 
dry, hard, and uncomfortable. It is best made by slowly 
sprinkling the meal into boiling water, stirring vigorously 
meanwhile, and afterwards incorporating with it a certain 
amount of olive oil, which prevents its adhering to the 
surface. [A piece of oiled silk should be placed outside of 
the poultice to retain its warmth and moisture.] Occasion- 
ally its use seems to irritate the skin, and cause a crop of 
small boils and painful pustules, and it must, therefore, as a 
general rule, be avoided in most cutaneous affections. 



SOLUTIONS — LITHIUM. 



363 



[Liquores 

The officinal Solutions are — 



Liquor Acidi Arseniosi 

" Ammonii Acetatis 

' ' Arsenii et Hydrarg. Iodidi 

" Calcis 

" Ferri Acetatis 
" " Chloridi 
" " Citratis 
" " et Quininse Citratis 
" " Nitratis 
" " Subsulphatis 
" " Tersulphatis 

" Gutta-perclise 

" Hydrargyri Nitratis 



Liquor Iodi Compositus 

" Magnesii Citratis 

" Pepsini 

" Plumbi Subacetatis 

" " " Dilutus 

" Potassse 

" Potassii Arsenitis 

" " Citratis 

" Sodse 

" " Chloratse 

" Sodii Arseuiatis 

" " Silicatis 

" Zinci Chloridi.] 



LITHIUM. 

[Lithii Benzoas. Benzoate of lithium. Dose, gr. v-xx 
(0.30 to 1.30 Gm.). 

Lithii Bromidum. Bromide of lithium. Dose, gr. 
v-xx (0.30 to 1.30 Gm.). 

Lithii Carbonas. Carbonate of lithium. Dose, gr. 
iij-vj (.20 to .40 Gm.). 

Lithii Citras. Citrate of lithium. Dose, gr. v-x (.30 
to .65 Gm.). 

Lithii Salieylas. Salicylate of lithium. Dose, gr. 
v-xxx (0.30. to 2. Gm.).] 



Physiological Effects. 

Lithia forms a very soluble 
salt with uric acid, probably 
in the blood, and, therefore, 
prevents the deposition of 
chalky formations in the tis- 
sues. 



It also causes an increase 
in the urinary secretion. 



Therapeutical. 

Lithia is, therefore, a valu- 
able remedy for gout, and 
uric acid gravel, given either 
in the form of effervescing 
lithia water, lithii carbonas, 
lithii citras, or the benzoate 
which is Garrod's favorite 
preparation. 

It, therefore, acts as a diu- 
retic perhaps more powerfully 
than any of the other alkaline 
salts. 



364 



LOBELIA, 



LOBELIA—LOBELIA. 

[ The leaves and tops of Lobelia inflata (N. 0. Lobeliaceoz) collected 
after a portion of the capsxdes have become inflated. 

Officinal Preparations, U. S. 

Aeetum Lobelias (10 per cent.). Dose, from gtt. x to 
f3j-ij (-65 to 8. Gra.). 

Tinetura Lobeliae (20 per cent.). Dose, m v to 3j 
(0.30 to 4 Gm.). 

Extraetum Lobeliae Fluidum. Dose,™ v-xx (0.30 
to 1.30 Gm.). 

Antidotes. 

The stomach should be washed out with warm solution of 
tannic acid, and symptoms of collapse treated as they arise, 
by stimulants, friction, counter-irritants, sinapisms, and 
anodynes.] 

Local Action. 
Lobelia possesses no local action. 



Internal Actions. 



Physiological. 

1. Brain and Nervous 
System — In large doses, lo- 
belia frequently causes head- 
ache and giddiness, and may 
eventually extinguish life by 
paralyzing the respiratory 
centre. 

2. Heart and Circulation. 
— Lobelia depresses the ac- 
tion of the heart, and in this 
respect has a powerful affinity 
to tobacco. 

3. Respiration and Tem- 
perature. — As already men- 
tioned, lobelia in large doses 
is a respiratory depressant, 
but in ordinary medical prac- 



Therapeutical. 



3. Lobelia is only used in 
medicine in this country as 
a remedy for various respi- 
ratory affections, and more 
especially spasmodic asthma. 



LUPULIN. 



365 



tice it seems to relieve spas- 
modic conditions of the bron- 
chial tubes. 

It lowers the temperature 
in some measure, on account 
of its diaphoretic action. 



Its action here is apt to be 
uncertain, and it may unex- 
pectedly cause much nausea 
and discomfort ; but Ringer 
tells us that we may employ 
it with great confidence by 
giving much larger doses than 
are usually prescribed. 

Remember that its action 
in no way prevents the asth- 
matic attack, but merely cuts 
it short. 

4. Lobelia is never used 
as an emetic, being slow, un- 
cerU 
ing. 



4. Secreting and Digestive 
Organs Lobelia has un- 
doubted emetic properties, 
and frequently causes vomit- 
ing, accompanied by much 
nausea and general depres- 
sion. 

Skin. — Lobelia excites the 
action of the skin. 

Kidneys — Lobelia is said 
to promote the excretion of 
watery fluids by the kidneys. 



Dose. 

Ringer tells us that the dose laid down in our usual text- 
books is much too small, and that we may freely administer 
a drachm of the tincture every hour, or ten minims every 
ten minutes, with advantage, immediately before and during 
the asthmatical paroxysm. [The vinegar of lobelia is said 
to be the best preparation for internal use.] 

The great drawback to its use is the occasional unpleasant 
symptoms following its administration, and which can be, 
unfortunately, neither foreseen nor prevented. 



[LUPULINUM—LUPULIN. 

The glandular powder separated from the strobiles of Humulus Lupulus, 
Linne* (N. 0. Urticaceoe, Cannabineoz) . 

(See Humulus, page 323.)] 
31* 



366 LYCOPODIUM — MAGNESIA. 



[LYCOPODIUM—LYCOPODIUM. 

The spondes of Lycopodium cJavatum, Linne", and of other species of 
Lycopodium (JV. 0. Lycopodiaceoz) . 

Lycopodium is an extremely light, very fine powder, of a 
delicate yellow color, inodorous, tasteless, and very inflam- 
mable, so that it flashes like gunpowder when thrown into 
the flame. It is^used as a dusting powder for chafing, but 
should not be used when the skin is broken. It is also em- 
ployed to coat pills in pharmacy.] 



MACIS— MACE. 

he fruit of Myrisi 
(N. 0. Myristio 

(See under Nutmeg, page 375.) 



The arittus of the fruit of Myrisiica fra grans', Houttuyn 
(N. 0. Myristicacece) . 



MAGNESIA. 
Officinal Preparations, U. S. 

[Magnesii Carbonas. Carbonate of Magnesium. 
Dose, 3 SS — 5U (2. to 8. Gm.). 

Magnesii Sulphas. Sulphate of Magnesium. (Ep- 
som salt.) Dose, gss-j (16. to 32. Gm.). 

Magnesii Sulphis. Sulphite of Magnesium. Dose, 
gr. xv-xxx (1. to 2. Gm.). 

Magnesia. Light Magnesia. Dose, 3j-i v (4. to 16. 
Gm.). 

Troehisei Magnesia? (each containing gr. iij). 

Liquor Magnesii Citratis. Dose, f^ij-viij (.60 to 
2.40 Gm.). 

Magnesia Ponderosa. Heavy Magnesia. Dose, 
3*s-ij (2. to 8. Gm.). 

Ferri Oxidum Hydratum cum Magnesia. (See 
Iron.) 

Pulvis Rhei Compositus. (See Rhubarb.) 

Mistura Magnesia? et Asafoetida?. Dewees's Car- 
minative. (Magnes. carb., 5; tr. asafoetid., 7; tr. opium, 1 ; 
sugar, 10; water q. s. ad 100 parts.) Dose, 3 ss ~j (2 to 4 
Gm.). 

Magnesii Citras Granulatus. Granulated Citrate. 
Dose, 3j-i y (4 to 16 Gm.).] 



MAGNESIA. 



367 



Interna-l Uses. 



Magnesia and its carbon- 
ate have a great capacity for 
saturating and neutralizing 
acid, and secondly, on becom- 
ing converted into bicarbon- 
ate by the carbonic acid of 
the intestines, they produce 
a mildly laxative effect. 

Sulphate of magnesium acts 
much more powerfully, and 
causes profuse watery evacu- 
ations, and its. action may be 
thus explained : — 

In virtue of its low diffu- 
sive power, it does not readily 
find its way into the blood, 
but remaining in the intes- 
tines, it attracts and firmly 
retains the watery fluid it 
finds there, and thus prevents 
its reabsorption. But in ad- 
dition to this, and to increas- 
ing the intestinal secretion, 
recent experiment has shown 
that it also actually with- 
draws fluid from the veins, 
as proved by the rapid way 
in which a small portion of 
intestine isolated from the 
rest of the tube becomes filled 
with watery fluid after the 
introduction of sulphate of 
magnesium. 

That this is not entirely 
due to exosmosis is rendered 
probable by the fact that the 
blood contains a greater pro- 
portion of saline matter than 
many mineral waters, besides 
which we know that albumi- 
nous or colloidal solutions like 



They are therefore antacid, 
and relieve pain or heart- 
burn, and are also gentle 
purgatives, much used, more 
especially for children. Their 
tendency, however, to form 
concretions, when employed 
too long, limits their use in 
this respect. 

Sulphate of magnesium is a 
very commonly used purga- 
tive in doses of from 3J t0 
§ss in simple constipation, 
in the early stages of small- 
pox and feverish conditions, 
in chronic lead-poisoning, 
and combined with iron, in 
many atonic conditions of the 
system. 

[Dr. Matthew Hay has 
shown that pleural and 
other serious effusions may 
be rapidly carried off by the 
administration of sulphate 
of magnesium, at the same 
time restricting the amount 
of fluid drunk.] 



It has been credited with 
cholagogue properties, but 
Rutherford has shown, on the 
contrary, that it actually 
lessens the hepatic secretion. 
The principal mineral waters 
containing this salt are I>ir- 
menstorf in Switzerland, 



368 MAGNOLIA. 

serum dialyze with difficulty, Pullna in Bohemia, Seidlitz 
so that the exosmosis ought and Friedrichshall in Saxony. 
in reality to be from the in- 
testine towards the blood. 
The experiments of Ruther- 
ford have shown that mag. 
sulph. is a powerful stimulant 
to the intestinal glands ; an 
action which may be at once 
checked by paralyzing the 
sensibility of the gut by a 
little laudanum. 

Mode of Administration. 

As sulphate of magnesium is not only very nauseous, but, 
when taken alone, may cause griping, straining, or uncom- 
fortable abdominal distension, it is usually prescribed in com- 
bination with senna, cardamom, and licorice, as in the 
mist, sennse co. [Br.], or with a little acid and sulphate of 
iron, both of which seem to increase its purgative properties; 
and it is well to remember that free dilution also seems to 
enhance its effects. The following are good formulae : — 

]£. Magnesii sulphatis 

Syrupi zingiberis 

Infusi rosse q. s. ad f'^viij M. 

S. |j tertis horis. 

fy. Magnesii sulphatis 
Ferri sulphatis 
Acidi sulphurici dituti 
Infusi quassise 
Misce, fiat mistura, cujus capiat unciam unam omni mane. 

fy. Magnesii sulpliatis ,^ij ; or 64 Grm. 

Magnesii carbonatis 3ii I " 8 " 

Syrupi zingiberis f^j ; " 23 " 

Aquas ment. piperita q. s. ad f^viij ; " 255 " 
Misoe, fiat mistura. Sumat unciam unam quartis horis ad 

effectum, phiala prius bene agitata. 



iii; 

f gss ; 
q. s. ad ffviij ; 


or 64 

" 16 
" 256 


Gm. 


gr. xxxiv 
uti fgij ; 
q. s. ad f§viij ; 


or 64 
" 1 
" 8 

" 256 


Gm. 

60 " 
a 

u 



MAGNOLIA—MAGNOLIA. 

[ The bark of Magnolia glauca, Magnolia acuminata, and Magnolia 
tripetala, Linni (N. 0. Magnoliacece). 

This drug has been introduced into the Pharmacopoeia in 
the effort to extend the knowledge of our indigenous Materia 



MALT — SULPHATE OF MANGANESE. 369 

Medica. It contains a bitter neutral principle, Magnolin, 
which is crystallizable ; insoluble in water, but soluble in 
alcohol. A fluid extract made with the aid of alcohol can 
be used as a bitter, aromatic tonic, in doses of tti,xxx-i'5Jss 
(2. to 6. Gm.).] 



MALTUM— MALT. 

[ The seed of Hordeum distichum (N. 0. Graminacece) caused to enter 
the incipient stage of germination bij artificial means and dried. 

Extraetum Malti (Extract of Malt). Dose, 3j-iv 
(4to 16 Gm.). 

The extract of malt contains malt sugar, dextrose, and 
diastase. It is therefore useful as an easily assimilable food, 
and assists in the digestion of carbo-hydrates. It is usually 
given in combination with milk. The imported German 
malt extract is an alcoholic preparation and can be used 
where a little alcohol is needed to stimulate gastric digestion.] 



[MANGANI OXIDUM NIGRUM. 

Native crude Binoxide of Manganese containing at least 66 per cent, of 
the pure oxide. 
(Mn0 2 =86.)] 



MANGANI SULPHAS—SULPHATE OF MAN- 
GANESE. 

Dose, gr. v-xx (.30 to 1.30 Gm.). 

Internal Effects and Uses. 

Sulphate of manganese acts as a purgative in doses of 5j-ij 
(4. to 8. Gm.), and in smaller doses has cholagogue properties. 
It has been used as a substitute for iron, as a hcematinic. 
Dr. Hammond reports its successful use in chorea. In 
divided doses it has been given in gastralgia, pyrosis, and 
indigestion. The binoxide has been given internally in 
dysmenorrhcea due to defective supply of blood to the ovaries. 
Dose, gr. v-xx (0.30 to 1.35 Gm.).] 



370 MANNA — MASTIC. 



MANNA— MANNA. 

[ The concrete saccharine exudation of Fraxinus Ornus, Linne" 
(N. 0. Oleacece). 

Infusum Sennae Compositum. Black Draught 
(Senna 6; manna 12; magnes. sulph. 12; f'cenic. 2; boiling 
water q. s. ad 100 parts). Dose, gj-iv (32 to 120 Gm.).] 

Internal Effects and Uses. 

Has very slight purgative properties. [It is generally 
given in infusion combined with senna, but may be used 
alone boiled in milk for children, to whom its sweet taste 
makes it acceptable. Dose for a child, 3j-"j (4. to .12 
Gm.).] 



[MARRUBIUM—HOREHOUND. 

The leaves and tops of Marrubium vulgare, Linni (iV. 0. Labiatce). 

Used as a domestic remedy for coughs and colds and as a 
diaphoretic, in the form of decoction (^j to Oj), syrup, and 
candy.] 



[MASSJE— MASSES. 

The officinal Masses are Massa Copaibas, Massa Ferri 
Carbonatis, and Massa Hydrargyri.] 



MASTICHE— MASTIC. 

[A concrete resinous exudation from Pistacia Lentiscus, Linne* 
(N. 0. Terebinthaceoz, Anacardiece) . 

Pilulae Aloes et Mastiches. (See Aloes.)] 

This is only used as a [temporary] filling for decayed 
teeth in dental surgery. 



MATICO — HONEY. 371 

MATICO—MATTCO. 

[The leaves of Artanthe elongata, Miquel (N. 0. Piperacece). 

Officinal Preparations, U. S. 

Extraetum Matieo Fluidum. Dose, f^ss-j (2. to 
4. Gm.).] 

Tinctura Matieo (10 per cent.). Dose 5j to ij (4. to 
8. Gm.).] 

Matieo is only used externally as a local application for 
the arrest of hemorrhage ; and it is generally believed that 
it acts mechanically by the roughly-reticulated under surface 
of the leaf entangling the blood and forming clots. No suc- 
cess has attended its internal administration. [In the form 
of the fluid extract, Matieo has been used and recommended 
in hemorrhages and diseases of mucous membranes, includ- 
ing gonorrhoea and leucorrhcea.~\ 



[MATRICARIA— GERMAN CHAMOMILE. 

The flower-heads of Matricaria Chamomilla, Linne (N. 0. Composite?). 

Resembles chamomile in its properties, but is rarely used 
in America.] 



[MEL— HONEY. 

A saccharine secretion deposited in the honey-comb by Apis mellifica, Linn6 
(Class Insecta; Order Hymenoptera) . 

Officinal Preparations, U. S. 

Mel Despumatum. Clarified Honey. Used as a 
vehicle. 

Confeetio Rosffi. Used as a vehicle. 
Mel Rosffi. Used as a vehicle. 

Its agreeable taste and demulcent qualities make honey 
a useful vehicle for distasteful powders, and render it an ac- 
ceptable addition to gargles. Purified honey is a good ex- 
cipient for pills,, and forms the basis of the Mellita, which 
are used chiefly in washes for the throat and mouth.] 



372 MELISSA — SPEARMINT. 

[MELISSA—MELISSA (BALM). 

The leaves and tops of Melissa officinalis. 

Balm has a fragrant odor ; and an aromatic, bitter taste ; 
it contains a volatile oil of an agreeable lemon-like odor. It 
resembles peppermint in its effects upon the stomach. A 
fluid extract would be the most eligible preparation given in 
doses of f5j-ij (4 to 8 Gm.).] 



[MENISPERMUM— MENISPERMUM (CANADIAN 
MOONSEED). 

The rhizome and rootlets of Menispermum Ganadense, Linn/ (2V. 0. Men- 
ispermacece) . 

Contains berberine, and therefore has some tonic proper- 
ties. In large doses it is laxative and diuretic. Dose, 3j- 
iv(4 to 16 Gm.), best given in the form of fluid extract.] 



[MENTHA PIPERITA— PEPPERMINT. 

The leaves and tops of Mentha piperita (N. 0. Labiatce). 

MENTHA VIRIDIS— SPEARMINT. 

The leaves and tops of Mentha viridis (N. 0. Labiatce). 

Officinal Preparations, U. S. 

Aqua Mentha? Piperita?. Used as a vehicle. 

Oleum Mentha? Piperita?. Dose, gtt. iij-v (.20 to 
.30 Gm.). 

Spiritus Mentha? Piperita?. Dose, gtt. x-xx (.65 
to 1.30 Gm.). 

Troehisci Mentha? Piperita?. Dose 1 to 5. 

Pilula? Rhei Composita?. 

Vinum Aromatieum. (See page 95.) 

Aqua Mentha? Viridis. Used as a vehicle. 

Oleum Mentha? Viridis. Dose, gtt. iij-v (.20 to 
.30 Gm.). 

Spiritus Mentha? Viridis. Dose, gtt. x-xx (.65 
1.30 Gm.).] 



MEZEREON. 373 

Menthol, a crystalline solid, derived from Chinese and 
Japanese oil of peppermint, may be used with benefit as a 
local application in neuralgia, and other painful affections; 
and it has recently obtained a wide domestic popularity under 
the name of " neuralgic crystal." 

[Peppermint and spearmint are favorite stimulant stom- 
achics, and are much used as vehicles in mixtures. The 
trochees of peppermint are a popular carminative. The oil of 
peppermint is used sometimes as a counter-irritant in neural- 
gia, following the Chinese practice. Peppermint-water is 
an excellent application in cases of pruritus pudendi. It is 
rendered more effective by the addition of an alkali, thus : 
to a pint of water add a drachm of borax, and six or eight 
drops of oleum menthse piperita?. Mix and use as a lotion.] 



MEZEREUM— MEZEREON. 

\The bark of Daphne Mezereum, Linn<?, and of other species of Daphne 
(iV. 0. Thymelaceoej. 

Officinal Preparations, U. S. 

Extraetum Mezerei. External use. 

Extraetum Mezerei Fluidum (used in Ung. 
Mezerei). 

Unguentum Mezerei (a stimulant dressing).] 

Decoctum Sarsaparillffi Compositum. Dose, 
(see Sarsaparilla.) 

Extraetum Sarsaparilla^ Compositum Flui- 
dum. 

Linimentum Sinapis Compositum. (See Mus- 
tard.) 

Only used in combination with other remedies, as sarsapa- 
rilla, guaiac, etc. It contains a bitter glucoside, daphmne, 
an acrid volatile oil, and resin. The powder is irritating 
and causes sneezing. In syphilis, scrofula, chronic rheuma- 
tism, and skin affections it has been used with asserted good 
results. Dose, gr. v-xv (.33 to 1. Gm.). 



32 



3t4 MIXTURES — MUSK. 

[Misturse. 

The officinal Mixtures are — 

Mistura Anmioniaci Mistura Ferri et Ammoini Ace- 
" Amygdalae tatis 

" Asafoetidaa " Grlycyrrhizae Composita 

" Chloroformi " Magnesii et Asafoetidaa 

" Cretae . " Potassii Citratis 

" Ferri Composita " Rhei et Sodae.] 



MOSCHUS— MUSK. 

[The dried secretion from the preputial follicles of Moschus Moschi- 
ferus, Linne* (Class Mammalia, Order Ruminanlia) . 

Officinal Preparation. 

Tinetura Moschi (10 per cent.). Dose, 3 ss ~j (2 to 
4 6m.). 

Internal Effects. 

Has undoubted antispasmodic powers, but has been almost 
entirely discarded on account of its high price and frequent 
adulteration. It may be given in doses of gr. v-xv (.30 to 
1. Gm.), in hysterical convulsions, hiccough, in low fevers 
and delirium tremens. An efficient substitute for musk is 
Castoreum, see page 205.] 

Musk is stimulant and antispasmodic, and was formerly 
much valued in France, and by Graves, of Dublin, in typhus, 
pneumonia, and other diseases tending to assume an adyna- 
mic type ; but it has now also fallen into comparative disuse. 



[Mueilagines. 

The officinal Mucilages are — 

Mucilago Acaciae Mucilago Tragacanthae 

" Sassafras Medullae " Ulmi.] 



MACE — MYRRH. 3^5 



MACLS— MACE. 



[The aryllus of the fruit of Myristica fragrans (Houttuyn, 
Nat. Hist.). 



MYRISTICA— NUTMEG. 

The kernel of the seed of Myristica fragrans, Houttuyn, deprived of 
its testa (xV. 0. Myristicaceoz) . 

Officinal Preparations, U. S. 

Pulvis Aromaticus (Cinnamon 35, ginger 35, 
cardamom 15, and nutmeg 15). 

Spiritus Myristicae. Dose, f3j (4. Gm.). 

Oleum Myristicae. Volatile oil of Nutmegs. Dose, 
gtt. ij-iij (.12 to .20 Gm.).] 

Nutmeg enters into Acetum Opii, Pulvis Aromaticus, 
Spiritus Ammonise Aromaticus, Tinctura Lavandulae Com- 
posita, Tinctura Rhei Aromatica, Trochisci Cretse, Tro- 
chisci Magnesias, and Trochisci Sodii Bicarbonatis.] 

Nutmeg is rarely used in medicine save as a flavoring in- 
gredient. [The dose of Nutmeg or Mace in substance is 
gr. xv (1. Gm.). With its aromatic qualities, nutmeg unites 
considerable narcotic power, and in doses of 3ij-iij (8. to 12. 
Gm.) has produced stupor and delirium.] 



MYRRHA— MYRRH. 

[J. gum-resin obtained from Balsamodendron Myrrha, Nees (N. 0. 
Burseraceoz) . 

Dose, in substance, gr. x-xxx (.65 to 2. Gm.). 

Officinal Preparations, U. S. 

Tinctura Myrrhae (20 per cent.). Dose, f3ss-j (2. 
to 4 Gm.). 

Tinctura Aloes et Myrrhae. Dose, f3j-'j (4. to 
8. Gm.). (See Aloes.) 

Pilula3 Aloes et Myrrhas. Rufus's Pills. (See 
Aloes.) 



3Y6 



MYRRH. 



Also enters into Mistura Ferri Composita, Pilulse Ferri 
Composite, Pilulse Galbani Composite, and Pilulae Rhei 
Composite.] 



Local Uses. 



Physiological. 



Myrrh is astringent, and 
checks excessive secretion 
from mucous surfaces. 



Therapeutical. 



It is a useful addition to 
gargles in relaxed or ulcer- 
ated conditions of the throat; 
it is a good application to 
spongy or unhealthy gums, 
as in mercurial salivation ; 
and it often forms one of the 
active constituents of lotions 
for foul ulcers, where it gently 
stimulates the granulating 
surface, and corrects the 
fetor of discharges. 



Internal Uses. 



Like all the gum balsams 
and resinous substances, 
myrrh may possess in some 
degree the power of stimu- 
lating mucous surfaces. Tra- 
dition and the habit of pre- 
scribes have also invested it 
with some supposed influ- 
ence over the uterus ; but no 
trustworthy evidence has ever 
been brought forward on this 
point, and it is more than 
probable that its emmena- 
gogue influence is quite secon- 
dary to the other drugs in 
combination with which it is 
prescribed in these cases. 



$. Aluminis gij ; 

Tincturae myrrhse f 5*j ; 

Infusi rosse acidi q. s. ad f §x ; 
Misce, fiat gargarisma. 



Myrrh has occasionally 
been used as a stimulant in 
chronic bronchitis, but prac- 
tically its application in medi- 
cine is now restricted to the 
administration of the various 
forms of pill in amenorrhea ; 
and here it is impossible to 
separate its action from the 
aloes with which it is invari- 
ably combined. 



or 



320 



Gm. 



NUX VOMICA. 377 

NUX VOMICA— NUX VOMICA. 

[The seed of Strychnos Nux Vomica, Lirnn.6 (JV. 0. Loganiacece) . 
Dose, in substance, gr. j-iv (.065 to 25 Gm. ). 

Officinal Preparations, U. S. 

Abstraetum Nueis Vomicae. Dose, gr. \ to ij 
(.03 to .13 Gm.). 

Tinetura Nueis Vomicae (20 per cent.). Dose, 
ttt^v-xx (.30 to 1.30 Gm.). 

Extraetum Nueis Vomica?. Dose, gr. \ to \ (.015 
to .03 Gm.). 

Extraetum Nueis Vomica? Fluidum. Dose, 
ni j-iv (.06 to .25 Gm.). 

Strychnina and Strychnin® Sulphas. Dose, gr. 
_i_ to T V (.002 to .005 Gm.).] 

Poisonous Effects. 

Strychnine kills by inducing hyper-excitability of the reflex 
functions of the spine, with violent tetanic spasms, leading 
to death by exhaustion or suffocation. The fatal event may 
take place in a few minutes if the dose be a large one, and 
the minimum quantity required to destroy life is about half 
a grain. Contrary to the habits of other poisonous drugs, 
strychnine acts most rapidly and efficiently when given by 
the rectum. 

Antidotes. 

In a case of strychnine-poisoning, we may first administer 
tannin, which places the drug in an insoluble form, then, 
after evacuation of the stomach, it will be necessary to try 
the physiological antidotes. These are chloral, bromide of 
potassium, Calabar bean, and nicotine [or tobacco enemata], 
although the use of the last-mentioned remedy must be con- 
ducted with extreme caution. Finally we may have recourse 
to artificial respiration. [The Musculus Venenosus, a poi- 
sonous shell-fish, has been used by Dr. F. Crump, of Tralee, 
Ireland, in a case of traumatic tetanus with complete suc- 
cess. It produces complete loss of power in voluntary mus- 
cles (U. S. Dispensatory 1888, p. 1862). Possibly it might 
be useful in strychnine convulsions also.] 

32* 



378 



NUX VOMICA. 



[Tests. 

Strychnine may be recognized by rubbing a small por- 
tion with a few drops of sulphuric acid containing one-hun- 
dredth of its weight of nitric acid. No change ensues ; but 
the addition of a very small quantity of the peroxide of lead, 
or of bichromate of potassium, changes the solution to a blue 
color, then to a red, and in the course of a few hours to a 
yellow color. Commercial strychnine sometimes affords a 
red color, changing to a yellow, with nitric acid, owing to 
the presence of brucia. 

Brucine is colored red by nitric acid, and this color 
changes to violet by the addition of protochloride of tin. 
With chlorine it gives a red color. Sulphuric acid first red- 
dens brucine, and then turns it yellow and green.] 

Local Action. 
No special local action has been noted. 

Constitutional Action. 
1. Brain and Nervous Sys- 1. Nux vomica, and more 



tern — No effect is produced 
on the brain, the cerebral 
functions remaining unim- 
paired almost up to the close 
of a case of strychnine-poi- 
soning. 

The spinal cord, however, 
is early attacked, and violent 
and distressing tetanic spasms 
prove the irritating influence 
of the drug, more especially 
on the reflex excitability of 
that organ. 

In large doses, strychnine 
also paralyzes the efferent 
(motor) nerves, causing loss 
of power of voluntary move- 
ment. 

The sympathetic system is 
stimulated. 

It probably stimulates the 



especially strychnine, are ex- 
cellent nervine tonics, acting 
well in simple debility, ner- 
vous exhaustion, and inconti- 
nence of urine, and promot- 
ing the return of function 
after some forms of paraly- 
sis. When all inflammatory 
symptoms have subsided, 
strychnine may be prescribed 
in the hope of stimulating 
the spine to resume its duties 
and restoring tone to mus- 
cles which have long remained 
in a state of inactivity. Thus, 
in paraplegia, hemiplegia, 
diphtheritic paralysis, and 
wrist-drop, strychnine may 
well go hand in hand with 
galvanism when all evidence 
of irritation of the nervous 



NUX VOMICA. 



379 



vasomotor centre, raises the 
blood pressure, aids oxidation, 
and removes the products of 
waste, making the respira- 
tory movements quicker and 
deeper. 



2. Heart and Circulation. 
— Strychnine causes rise of 
arterial pressure and con- 
traction of the capillaries. 

3. Respiration and Tem- 
perature The interference 

with breathing observed in 
strychnine - poisoning, and 
which usually terminates the 
life of the victim, is due to 
spasmodic fixation of the 
diaphragm and respiratory 
muscles. 

4. Digestive and Secreting 

Organs Strychnine has a 

tonic influence over the di- 
gestive process, aiding oxida- 
tion, removing the products 
of waste, and delaying putre- 
faction. 



structures has completely 
disappeared. Trousseau, 
Hammondand Finny, of Dub- 
lin, praise it in chorea. Mr. 
Barwell has proposed subcu- 
taneous injections of strych- 
nine in infantile paralysis, 
using a large dose (Jg to y 1 ^ 
gr. (.005 Gm.), and forcing 
the fluid freely into the mus- 
cular structures. 

Annandale, of Edinburgh, 
has recorded an interesting 
case of writer's palsy success- 
fully treated by subcutaneous 
injections of strychnine, using 
equal parts of the liquor and 
water, injecting n^vj every 
second day, and gradually in- 
creasing the dose until n^xij 
was reached, the injections 
being made into the flexors 
and extensors of the fore-arm. 

2. It is an excellent heart 
tonic. 



3. Thorowgood praises 
strychnine and nux vomica 
most enthusiastically in para- 
lytic and emphysematous 
asthma. 



4. Strychnine, and more 
especially nux vomica, are 
excellent tonics, improving 
the appetite in a marked 
degree; but, in addition to 
this, nux vomica is of great 
service in various dyspeptic 



380 



NUX VOMICA. 



conditions, relieving heart- 
barn, nausea, and flatulence, 
and being also a reliable 
remedy in sick headache and 
the vomiting of pregnancy. 
It is an excellent addition to 
purgative pill masses, improv- 
ing the tone of the muscular 
wall of the intestines and re- 
lieving constipation. 



Dose, Mode of Administration, etc. 

The dose of strychnine may be put at from 3L to yL gr. 
(.002 to .005 Gm.), and the liquor [Br.] is a convenient 
form, in doses of from 5 to 10 minims, added to any ordi- 
nary tonic mixture. We are usually advised to suspend its 
administration from time to time, as it is stated that uncom- 
fortable twitchings and rigidity about the jaw may suddenly 
arise, giving evidence of the so-called "accumulation" of 
the drug. 

By hypodermic injection we are usually taught that gr. 
t Jq is the proper dose, and it is therefore difficult to under- 
stand why no poisonous results followed Barwell's somewhat 
heroic medication. 

f£. Ferri sulph. exsic. 

Quininge sulph. 

Stryclminse sulph. 

Maimse q. s. M. 

Fiant pilulse xx. Suuiat unam ter in die. 

A useful tonic pill. 

R. Tinct. nucis vomica? f 3.1 ; or. 4 Gm. 

Acidi nitro-muriaticidiluti f 3U I " 8 

Spi'ritus chloroformi f 3J ; " 4 

Infusi gentianse ad f$vj ; " 192 " M. 

S. Dose, f^j ter die sumend. 

For flatulent colic, taken after meals. 

I£. Ferri sulph., 

Ext. nucis vomicae, aa gr. ss ; or 103 Gm. 

Ext. aloes Barb. gr. iij ; " 1 20 " M. 

Fiat pil. ante cibum sumend. 

A good "dinner pill." 



gr. xl ; 


or 


2 


60 Gm. 


gr. xl ; 


ft 


2 


60 " 


gr. ss ; 


a 




03 " 



OILS — LEO- RE SINS. 



381 



[Olea. 



The officinal Oils are- 
Oleum Adipis 

" iEthereum 
Amygdala? Amarse 
Dulcis 
Anisi 

Aurantii Corticis 
" Florum 
Bergamii 
Cajuputi 
Cari 

Caryophylli 
Chenopodii 
Cinnaraomi 
Copaibas 
Coriandri 
Cubeba? 
Erigerontis 
Eucalypti 
Foeniculi 
Graultheria? 
Gossypii Seminis 
Hedeoma? 
Juuiperi 
Lavandula? 

" Florum 

Limonis 



Oleum Lini 

Mentha? Piperita? 

Mentha? Viridis 

Morrhuse 

Myrcia? 

Myristicse 

Oliva? 

Phosphoratum 

Picis Liquida? 

Pimentse 

Ricini 

Rosa? 

Rosmarini 

Ruta? 

Sabina? 

Santali 

Sassafras 

Sesami 

Sinapis Volatile 

Succini 

Terebinthina? 

Theobroma? 

Thymi 

Tiglii 

Valeriana?.] 



[Oleata. 

The officinal Oleates are — 
Oleatum Hydrargyri Oleatum Veratrina? 



[Oleo-resina?. 

The officinal Oleo-resixs are — 



Oleo-resina Aspidii 
" Capsiei 

" Cubeba? 



Oleo-resina Lupulini 
Piperis 
Zingiberis.] 



382 ETHEREAL-OIL — COD-LIVER OIL. 



[OLEUM iETHEREUM— ETHEREAL OIL, U. S. 

A volatile liquid consisting of equal volumes of Heavy Oil of Wine 
and of strong JEther. 

Heavy oil of wine is a limpid, almost colorless, volatile 
fluid, of a pungent taste and vinous odor. Its solution in 
alcohol and ether is officinal as Spiritus ^Etheris Compositus 
(see page 140), but it is never prescribed alone.] 



OLEUM MORRHUA— COD-LIVER OIL. 

A fixed oil obtained from the fresh liver of Gadus morrhua, Linns', or of 
other species of Gadus (Class Pisces, Ord. Teleostia, Fam. Gadida). 

Local Actions. 

Cod-liver oil is not used in virtue of any local action, as 
its nauseous smell effectually prevents it from forming the 
basis of ointments or liniments. Being very readily absorbed 
by the skin, however, it is occasionally introduced into the 
system by this channel when the patient is unable to take it 
by the mouth, and I have seen most excellent results pro- 
duced in strumous, rickety, and syphilitic infants in this way. 

Constitutional Actions. 
Physiological. Therapeutical. 

1. Brain and Nervous 1. It is therefore specially 
System. — Cod-liver oil can indicated in all nervous affec- 
only be said to act on the tions dependent on debility, 
nervous system by improving such as neuralgia, some 
its nutrition and supplying forms of insanity, asthma, 
the fatty ingredients neces- whooping-cough, etc. 

sary for growth and repair. 

2. Circulation It has a 2. It is therefore much 

tonic influence on the circu- used in simple debility, in 

lating organs, by improving convalescence from acute ill— 

the quality of the blood, and ness, in ancemia, tertiary 

strengthening the heart mus- syphilis, and other weakened 

cles. It has been shown that conditions of the system. 

it increases the number of 
red corpuscles of the blood. 

3. Respiration and Tern- 3. Under this heading we 



COD-LIVER OIL. 



383 



perature No special physi- 
ological influence is exerted 
on either of these functions. 

[Morrhuol, which repre- 
sents the active principles of 
the oil, minus the fat, is 
claimed to have special value 
as an alterative when the 
ordinary preparations are not 
well borne by the patient. It 
is given in smaller doses, as 
it represents twenty-five times 
its weight of cod-liver oil.] 



4. Digestive and Secreting 
Organs. — It has been proved 
by experiment that animal 
are much more digestible 
than vegetable oils, probably 
on account of containing bile, 
and cod-liver oil is the most 
readily assimilated of all. 
After being emulsified by the 
pancreatic juice, it comes in 
contact with the bile, which 
distinctly increases its power 
of passing through moist ani- 
mal membranes ; and it is 
probable also that the biliary 
principles incorporated in its 
own structure aid in enabling 
it to be easily absorbed by 
the lacteals. Its action on 
the system now is to improve 
the general constitutional 
tone, to evolve force and heat, 
and to aid in supplying those 
fatty elements which are so 
essentially requisite for the 



may place, for convenience, 
the wonderfully restorative 
effects of cod-liver oil in 
chronic lung disease, but 
more especially in the va- 
rious forms of pulmonary 
phthisis. It is beneficial in 
asthma and chronic bronchi- 
tis, but in consumption it 
really seems to be directly 
curative. It may be given 
with advantage in all stages, 
and under its use patients 
often rapidly gain flesh, and 
not only manage to hold the 
disease at bay, but even oc- 
casionally seem to escape 
from its clutches. 

4. Cod-liver oil is almost 
invaluable in diseases de- 
pending on defective nutri- 
tion, as in all scrofulous 
conditions, such as strumous 
ophthalmia, caries of bones, 
chronic joint-affections, glan- 
dular enlargements, etc. ; also 
in rickets and all the wasting 
disorders of childhood, in 
senile atrophy and decay, in 
chronic rheumatism, in all 
the ulcerative varieties of 
shin disease, and in advanced 
constitutional syphilis. Va- 
rious attempts have been 
made to explain the actions 
of the oil by means of certain 
special ingredients which it 
contains ; but none of these 
have been successful, and we 
cannot at present do more 
than attribute its restorative 
influence to its ready diges- 
tibility and nutritive proper- 



384 COD-LIVER OIL. 

construction and repair of ties, acting as it does as a 

the tissues. hydrocarbon in nourishing 

Cod-liver oil occasionally the body. Possibly, however, 

causes nausea, vomiting, and some therapeutic value may 

diarrhoea, and it has been be ascribed to minute quanti- 

shown to increase in some ties of iodine, bromine, and 

measure the biliary secretion, phosphoric acid, in its sub- 
stance. 

Mode of Elimination. 

The greater part of the oil is absorbed into the system, but 
a little is given off by the feces ; and it is well to watch the 
evacuations of children under its influence, to see whether 
any undigested oil escapes, this indicating an overdose. 

Drawbacks. Mode of Administration. 

Cod-liver oil occasionally produces so much nausea, eructa- 
tion, and discomfort, as to compel us to suspend its administra- 
tion ; but most patients, and more especially children, speedily 
grow accustomed to its use. An eruption of acne sometimes is 
caused by the passage of some of the acrid constituents of the 
oil through the cutaneous glands. It is advisable to prescribe 
it in small doses directly, or, even better, an hour after meals, 
or at bedtime, to give it with some light tonic, and to suspend 
it from time to time, more especially in hot weather, or when 
bilious symptoms supervene. It may well be given in combi- 
nation with a little alcohol beaten up with the froth of porter, 
with mucilage or lemon-juice floating on the top of a table- 
spoonful of water in which a pinch of ordinary table salt has 
been dissolved, or with from rr^x to f5j of aether puris, which, 
Dr. B. Foster tells us, aids digestion by stimulating the pan- 
creatic secretion ; but if the pale oil is used, very few persons 
will be found entirely rebellious to its use. Children, as a 
rule, take it well, but if they prove obstinate we may give 
it with orange wine, or in the following combination : — 

Gm. 

<< 

(( 

30 " 

" M 



U Olei morrhuse f §ss ; 


or 


16 


Mucilaginis acacise f §ij ; 


1 1 


64 


Sacchari 5i) \ 


a 


8 


Tincturse lavandulse comp. n\xx ; 


<( 


1 


Aquae f §ss ; 


u 


16 


3s pro dosi. 







OIL OF MYRCIA — OLIVE OIL. 385 

[In private practice, Dr. Foster prefers to give it in the 
following mixture : — 

1$. Potassii bicarbonatis 5 iss -li "> 

Acidi bydrocyan. dil. rr^xij-xvj ; 

Spiritus getheris ^iss — ij ; 

Aquae q. s. ad 3 v iij 5 

Dose fj ter in die sumat.] 1 

An agreeable oil cream and jelly has been made ; we also 
may use it in biscuits or chocolate. 

Black coffee forms a good medium for adults, or we may give 
the oil floating on beer, porter, or on the following mixture : — 



6 


Gm 




75 " 


6 


it 


256 


a 



R. Acidi nitrici diluti tl^x ; or 

Acidi hydrocyanici dilut. tt\j-ij ; " 

Tincturse aurantii f 5 SS > " 2 

Aquas f§ss ; " 16 

The dose should never exceed half an ounce. 



65 Gm. 

06 " 



M. 



[A pancreatic emulsion of cod-liver oil, and an emulsion 
with the lacto-phosphate of lime, or one with lime-water 
flavored with oil of bitter almonds, are largely used for 
children, although not officinal. Equal parts of extract of 
malt and cod-liver oil make a mixture that is readily taken 
by children.] 



OLEUM MYRCIA— OIL OF MYRCIA (OIL OF 
BAY). 

[A volatile oil distilled from the leaves of Myrcia acris, De Candolle 
(N. 0. Myrtacece) . 

Spiritus Myreiae (Bay rum). Oil of myrcia 16, oil 
of orange peel 1, oil of pimento 1, alcohol 1000, water 782 
parts (to make 1800 parts). For external use.] 



OLEUM OLIV^E—OLIVE OIL. 

[J. fixed oil expressed from the ripe fruit of Olea Europcea, LinnS 
(N. 0. Oleacece). 

Olive oil is nutritious and laxative, and is occasionally 
used for children as a substitute for castor oil. Dose, for an 
adult, fgij-iv (64. to 128. Gm.). It is a useful remedy for 

1 [FotliergilPs Handbook of Treatment, Pbila. 1878.] 
83 



CASTOR OIL. 



all kinds of irritant poisoning except phosphorus in sab- 
stance. It is used largely in pharmacy.] 

Olive oil is only used externally as an emollient applica- 
tion, and as the basis of various liniments. fit enters into 
Emplastrum Plumbi and Unguentum Diachylon. J 



OLEUM RICINI— CASTOR OIL. 

[A fixed oil expressed from the seed of Ricinus communis, Linne 
(2V. 0. Eiiphorbiaceee). 

Enters into Collodium cum Cantharide and Collodium 
Flexile. 

Dose', 33-SJ (4. to 32. 6m.).] 

External. Uses, 

Castor oil is a substance of such bland and unstimulating 
quality, that, were its smell less offensive, it might form a 
valuable external agent in certain cases. It is, however, 
occasionally used as a soothing application to the eye when 
extreme temporary irritation has been set up by abrasion of 
the corneal epithelium. Castor oil will purge when rubbed 
into the skin. 

Internal Uses. 
Physiological. Therapeutical. 

Castor oil gently stimulates Castor oil is a mild and 

the peristaltic movements of efficient cathartic, emptying 

the intestinal canal, and the intestines without causing 

slightly augments the fluid griping or discomfort. It is 

secretions of the gut. Some therefore useful in all cases 

amount of astringent action where we simply wish to un- 

generally follows the purga- load the bowels; but it is not 

tive action of the drug. Cas- a good habitual purgative 

tor oil stimulates the intesti- from the subsequent constipa- 

nal glands, but not the liver, tion produced. This astrin- 

( Rutherford.) gent action, however, gives it 

The seeds are very irri- a special advantage in the 

tating, and cause gastro- treatment of diarrhoea, many 

intestinal irritation, three cases of which depend on 

having proved fatal to an the presence of irritating 

adult. matters in the intestinal 



OIL OF AMBER. 38Y 

canal; and under such cir- 
cumstances common sense 
naturally indicates the pro- 
priety of expelling the excit- 
ing cause. Dr. Geo. John- 
son, however, goes further 
than this, and advocates the 
" eliminative" treatment of 
all diarrhoeas, as well as of 
cholera. 

Dose and Mode of Administration. 

Although the best castor-oil has but little actual flavor, it 
leaves a greasy, sickly sensation on the palate, which is ex- 
ceedingly unpleasant. It is therefore important to give it in 
some form of combination, and we find floating the dose in a 
glass of cinnamon water, between two strata of whiskey or 
brandy, to be an effectual plan, or we may make use of the 
following formulae :- — 

££. 01. ricini f^ss ; or 16 j Gin. 

Mucilaginis aeaciae, 

Syrupi simplicis, aa f3'j ; " 8 " 

Aquse cirmaniomi q. s. ad f ^ij ; " 64 <{ M. 

Fiat baustus statim sumendus. 



$. 01. ricini f 5'ij ; 


or 


12 Om. 


Tinct. opii tr^x ; 


n 


65 " 


Syrupi zingiberis f §j ; 


t i 


4 


Aquae lnenth. pip. q. s. ad f^ij ; 


" 


64 " M. 


Fiat ba-ustus statim sumendus. 







Either makes a good prescription for the diarrhoea of irri- 
tation. 



[OLEUM SUCCINI— OIL OF AMBER. 

A volatile oil obtained by the destructive distillation of amber, and 
purified by subsequent rectification. 

Dose, gtt. v-xx (.30 to 1.30 Gm.). 

The oil of amber is stimulant and antispasmodic, and has 
been administered in bronchitis, hysteria, and obstinate hic- 
cough, and is also used externally, diluted with sweet oil, as 
a sedative and rubefacient for whooping-cough, or for in/an- 



388 CACAO BUTTER — OIL OF THYME. 

tile convulsions, as in the mixture recommended by Dr. Jos. 
Parrish : — 



I£. Olei succini rectificati, 

Tincturse opii, aa f^ss; or 16 

Olei olivse, 

Spiritus vini Gallici, aa f ^ij ; "64 

To be rubbed along the spine.] 



dm. 
" M. 



OLEUM THEOBROMiE— CACAO BUTTER. 

[-4 fixed oil expressed from the seed of Theobroma Cacao, Linne" 
(N. 0. Sterculiacece). 

Oil of theobroma, being a firm, solid, and agreeable sub- 
stance, is much used in the manufacture of suppositories, and 
entered into the following of the Pharmacopoeia of 1870 : — 

Suppositoria Acidi Carholici (each gr. j of carbolic acid). 



" Tannici 


C " 


gr. 


v of tannic acid). 


Aloes 


( " 


g r - 


v of purified aloes). 


Asafcetidae 


( " 


g r - 


v of asafoetida). 


Belladonna? 


( " 


gr. 


^ extract of belladonna) . 


Morphise 


( " 


gr. 


| sulphate of morphine). 


Opii 


( " 


gr 


j extract of opium). 


Pluinbi 


( " 


gr. 


iij plumbi acetatis). 


Plurnbi et Opii 


( " 


gr. 


iij plumbi acetatis and 
gr. ^ extract, opii). 



None of these are now officinal. Unless otherwise specified, 
suppositories are to be made with cacao butter, and shall 
each weigh about 15 grains or 1 gramme when completed. 
Cacao butter is a good agent to apply to prevent cracking of 
the nipples during nursing.] 



[OLEUM THYMI— OIL OF THYME. 

A volatile oil distilled from Thymus vulgaris, Linn6 (N. 0. Labiatm). 

The oil of thyme is said to furnish the greater part of the 
commercial oil of origanum. It is aromatic and counter- 
irritant, the oil being used almost exclusively as a local ap- 
plication, and as an ingredient in opodeldoc, the Linimentum 
Saponis Camphoratum of former editions of the Pharmaco- 
poeia.] 



CROTON OIL. 



389 



OLEUM TIGLII— CROTON OIL. 

[ A fixed oil expressed from the seed of Croton Tiglium, Linne* 
(N. 0. Euphorbiacece) . 

Dose, gtt. i-iv (.06 to .25 6m.).] 
Local Action. 



Physiological. 

The topical application of 
croton oil to the skin causes 
a good deal of irritation, fol- 
lowed by the appearance of 
a copious crop of papules, 
gradually developing into pus- 
tules. Dr. Tilbury Fox has 
described a symmetrical ery- 
thema of the face following 
this local employment ; and 
it- is said that the addition of 
an alkali favors the develop- 
ment of the counter-irritant 
properties of the drug. 

Its use in ringworm pro- 
duces an artificial imitation 
of a variety of the disease 
called kerion, in which the 
patches become raised, swol- 
len, red, and infiltrated (Al- 
der Smith). 



33 : 



Therapeutical. 

The local application of 
liniments containing croton 
oil was in former years a fa- 
vorite mode of using counter- 
irritation in various chronic 
lung- affections, and it is still 
employed, more especially in 
public practice. But its draw- 
backs are, that it has a ten- 
dency to overact on tender 
or irritable skins, and the 
pustules are liable to leave 
cicatrices, so that it is diffi- 
cult to believe it in any way 
superior to other and milder 
applications. Croton oil is 
an excellent application in 
ringworm, with the following 
precautions : — 

Be careful of its use in 
children under 6 or 7 years 
of age. 

Do not apply it at one 
time to a surface larger than 
a florin, and only to chronic 
cases, as it produces a good 
deal of inflammation, leaving 
an irritable and boggy condi- 
tion of parts, which must be 
removed by poulticing. Re- 
peat the painting next day, 
three or four applications 
being usually found sufficient. 



390 



CROTON OIL 



Internal Action. 



When taken internally, 
croton oil produces much irri- 
tation of the intestines, run- 
ning on, if the dose be suffi- 
ciently large, into a very fair 
imitation of the symptoms of 
cholera-poisoning, with vom- 
iting, extreme purging, col- 
lapse, and acute inflammation 
of the intestines. 

It is a hepatic stimulant 
of very feeble power. (Ruth- 
erford.) 



Croton oil, then, is a dras- 
tic purgative, valuable in cer- 
tain cases on account of its 
rapid and powerful action. 
Thus, in apoplexy and other 
cerebral affections, where it 
is of importance to obtain an 
immediate and thorough evac- 
uation of the bowels, and in 
some conditions of obstinate 
constipation, we find consid- 
erable advantage from its 
cautious use. 



Mode of Administration, etc. 

Croton oil has an acrid and irritating flavor, and is best 
given in the form of pill. Garrod, however, tells us that it 
may well be prescribed in combination with castor oil, and, 
in case the patient is unable to swallow, it may be placed on 
the back of the tongue. 

In an extreme case we might expect to obtain some pur- 
gative effect from rubbing it into the skin, as it appears to 
act by absorption through this channel. 

$. Olei tiglii . ntij ; or |12Gm. 

Micse panis q. s. M. 

Fiat pilula, statim sumenda, et horis duabus repetenda 
si opus sit. 

Or we may endeavor to keep its irritating properties in 
check by prescribing it in the following combination : — 



#. 01. tiglii TUiij ; or 

Ext. colocjnth. oomp. gr. xx ; " 
Ext. belladonnae ale. gr. jij ; 



20 Gm. 
30 " 
20 " 



Mi 



divide in pil. vj, quarum suiriat imam si opus sit. 



For external use, a very good liniment is contained in th 
British Pharmacopoeia. 



opium. 391 



OPIUM—OPIUM. 

[ The milky exudation obtained in Asia Minor by incising the unripe cap- 
sules of Pa paver somniferum, Linne* (N. 0. Papaveracece), (yielding 
not less than nine per cent, of morphine). 

Dose, gr. j-ij (.06-0.13 Gm.). 

Officinal Preparations, U. S. 

Opii Pulvis (Powdered opium, containing not less than 
12 nor more than 16 per cent, of morphine). Dose, gr. 
ss-i (.03 to .06 Gm.). 

Opium Denareotisatum (Denarcotized Opium 
should yield 14 per cent, of morphine). Dose, gr. ss-j (.03 
to .06 Gm.). 

Pilulas Opii (gr. j). Dose, 1 to 2. 

Extractum Opii (double strength of opium). Dose, 
gr. ss to j (.03-.06 Gm.). 

Emplastrum Opii (extract 1 in 16). 

Troehisei Glycyrrhizas et Opii (gr. 1 of extract 
to 20). 

Pulvis Ipecacuanhas et Opii (Dover's Powder). 
(Ipecac and opium, aa 1, sugar of milk 8 parts). Dose, 
gr. x (.65 Gm.). 

Tinctura Opii (Opium, gr. j in ft\,xiij). Dose, n^x- 
xx (0.65 to 1.30 Gm.). 

Mistura Magnesii et Asafetida (Tr. opii 1 per 
cent.). (See Magnesia). 

Tinctura Opii Camphorata (Paregoric Elixir, gr. j 
of opium in fgss) Dose, t 3j to ,^j (4. to 32. Gm.). 

Tinctura Opii Deodorata (gr. j in ni^xiij). Dose, 
TT^x to xx (0.65-1.30 Gm.). 

Tinctura Ipecacuanhas et Opii (same strength as 
Dover's Powder). Dose, n^v-x (.30 to .65 Gm.). 

Acetum Opii (10 per cent.). Black drop. Dose, 
ttl,v-xx (.30 to 1.30 Gm.). 

Mistura Glyeyrrhizas Composite. (See Glycypc- 

RHIZ^E). 

Troehisei Morphinse et Ipecacuanhas (each gr. 
? \y). Dose, 1 to 5. 

Vinum Opii (10 per cent,). Dose, rr^viij (.50 Gm.). 
Pulvis Morphinas Compositus (Tully's Powder, 



392 opium. 



morph. sulph. <*r. j, camphor, licorice, precip. carbonate of 
calcium, aa gr. xx). Dose, gr. v-x (0.30 to 0.65 Gra.). 

Codeina. Dose, gr. J to \ (.01 to .03 6m.). 

Morphina "\ 

Morphine Aeetas ( Dose, %r. T 1 ^-^ (.006 to 

Morphine Hydroehloras j .03 Gm.).] 

Morphine Sulphas J 

Poisonous Action. 

When opium has been given in a poisonous dose the re- 
sulting sleep gradually grows deeper, the breathing becomes 
heavy and stertorous, the face flushed, swollen, and dusky, 
the pupils contracted to mere points, distension of the right 
side of the heart still further prevents the return of blood 
from the engorged lungs, and paralysis of the respiratory 
centre finally causes death by suffocation. Much difficulty 
may occasionally attend the diagnosis of opium-poisoning 
from (1) alcoholic coma, where, however, the pupils are 
usually dilated; (2) from uremic coma, where an examina- 
tion of the urine, if practicable, might clear up our doubts; 
and (3) from apoplectic effusion in the pons Varolii, where 
the symptoms are usually so similar as to render an absolute 
diagnosis, under certain circumstances, impossible. After 
death we find well-marked congestion of the brain. 

Treatment and Antidotes. 

When summoned to a case of opium-poisoning, the first 
indication must be to evacuate the stomach, and this is best 
effected by the stomach-pump, as the vomiting centre is too 
much paralyzed by narcosis to allow of its effective stimula- 
tion by emetics. We then try to counteract the tendency to 
sleep by cold affusion, irritation of the skin, strong coffee, 
galvanism, and walking the patient about, and, finally, we 
may cautiously use atropine as the physiological antidote. 
Although evidence comes to us from China of opium-poison- 
ing checked by the antagonistic action of atropine, reports 
and opinions differ much on this head, and some authorities 
hold that atropine in certain proportions may even intensify 
the action of morphine. 

Professor Bennet believes that atropine may be of service 
by contracting the vessels of the brain, and limiting the 
tendency to cerebral congestion. 



OPIUM. 



393 



As a last resource, we may have recourse to artificial 
respiration. 

[Faradism is of great service in maintaining the action 
of the diaphragm and other respiratory muscles.] 

Local Action. 



Physiological. 

It seems very doubtful 
whether opium can be ab- 
sorbed through the unbroken 
cuticle. We are told that 
opium inspectors in India 
will remain for hours with 
their arms plunged up to the 
elbows in the inspissated ex- 
tract, and that no narcotic 
effect is produced ; but it is 
difficult, on the other hand, 
to believe that opium is en- 
tirely devoid of a property 
which belladonna possesses 
in so remarkable a degree. 
Sir Henry Thompson is also 
strongly of opinion that the 
bladder cannot absorb opium, 
but on this point more precise 
evidence is wanted. 



Therapeutical. 

Fomentations with the de- 
coction of poppy-heads, and 
with other preparations of 
opium, have long been re- 
cognized as efficient means 
for the relief of pain in vari- 
ous inflammatory conditions, 
as hemorrhoids, erysipelas, 
conjunctivitis, etc. ; but as 
we cannot bring forward evi- 
dence of absorption of the 
drug, we must merely attri- 
bute this soothing influence 
to the thorough application 
of moist heat. [It is stated 
by Ringer that opium in com- 
bination with poultices or 
liniments is absorbed through 
the integument.] 



Internal Actions. 



I. On Nervous System — 
1. Brain — In small quan- 
tity, or temporarily as the 
occasional preliminary action 
of a truly narcotic dose, 
opium is gently exciting to 
the brain, the intellectual 
faculties becoming generally 
stimulated, and the imagina- 
tion more vivid. To this, 
however, rapidly succeeds a 
dulling or deadening effect, 
drowsiness supervenes, and 



I. — 1. Opium, being the 
most certain narcotic known, 
is very largely prescribed in 
a great variety of cases. In 
simple insomnia, in worn-out 
conditions of the nervous 
system, in acute fevers, such 
as typhus and typhoid, where 
delirium and sleeplessness 
constitute truly dangerous 
complications, in delirium 
tremens, in the later stages 
of severe small-pox, in me- 



394 



OPIUM. 



deep sleep finally sets in, from 
which the patient wakes with- 
in a period of time propor- 
tioned to the quantity of the 
drug administered. Head- 
ache, dryness of the mouth, 
and digestive disturbance are 
frequently experienced, and 
idiosyncrasy may in some 
rare cases interfere materially 
with sleep by bringing into 
special prominence the ex- 
citing or stimulating proper- 
ties of opium. It is not quite 
clear in what precise way the 
narcotizing influence is in this 
instance produced ; but ana- 
logy would lead us to believe 
that contraction of the cere- 
bral vessels imitates natural 
sleep by inducing an anaemic 
condition of the gray matter 
of the brain. This might ap- 
pear to be contradicted by 
the deep cerebral congestion 
noted in the victims of opium 



poisonin< 



but Hammond lias 



shown by experiment that 
whilst the brain is anaemic in 
sleep caused by a large dose, 
as the slumber passes into 
coma engorgement of the 
veins sets in. The resulting 
contraction of the pupil is 
probably central in origin, as 
it cannot be produced by 
any local application of opium 
in any form. 

2. The conductivity and 
irritability of the sensory 
nerves are much diminished, 
so that pain is felt with less 
intensity. 



ningitis, acute mania, and 
in numerous other diseased 
conditions which the reader 
can readily recall, this inva- 
luable drug does most essen- 
tial service by procuring 
sound and refreshing sleep. 
It would clearly be outside 
the scope of this little book 
to go into any exhaustive 
discussion on the varied uses 
of opium as a narcotic in dis- 
ease, and we must refer our 
readers to the numerous and 
excellent works on the prac- 
tice of medicine. 



2. And even when not 
given in truly narcotic doses, 
it may also lull the sufferer 
into slumber by benumbing 
the sensory nerves and re- 



OPIUM. 



395 



3. The reflex function of 
the spinal cord is at first 
slightly increased, but sub- 
sequently becomes lessened 
in degree, and the respiratory 
centre is weakened and finally 
paralyzed. In cold-blooded 
animals, as the frog, in which 
the cerebral are subordinated 
to the spinal functions, opium 
causes most violent tetanic 
convulsions, and this has 
been observed in children. 



4. The sympathetic system 
of nerves is also primarily 



lieving pain. As a sedative, 
anodyne, or analgesic, it is 
indispensable in many painful 
conditions, such asneuralgia, 
sciatica, cancer, biliary or re- 
nal calculi ', labor after-pains, 
colic, etc.-, and as we shall 
presently see, the subcuta- 
neous injection of morphine 
is the most effectual, as it 
certainly is the most rapid 
and convenient, mode of ob- 
taining this action of the 
drug.^ 

Opium is also an excellent 
antispasmodic, and acts well 
by relieving irregular muscu- 
lar contraction, as in the in- 
testine causing colic, in the 
uterus tending to abortion 
or exhausting after-pains^ in 
spasmodic urethral stricture; 
and its remarkable influence 
over certain forms of obstinate 
ulceration must also be due 
to some nervous influence. 

3. Opium, having the 
property of arresting the 
muscular action of various 
organs, is our sheet-anchor 
in those terrible cases where 
rupture of the intestine, 
bladder, or uterus has oc- 
curred, and where the only 
possible chance of recovery 
consists in the most perfect 
rest of the viscus, encouraging 
the healthy process of repair, 
and preventing the escape of 
irritating secretions into the 
peritoneal cavity. 



396 



OPIUM, 



excited, and secondarily de- 
pressed. 

II. Vascular System. — 
The action of the heart is at 
first slightly quickened, but 
afterwards its beats become 
slower, the pulse fuller and 
firmer, and the arterial tension 
is raised, this effect being con- 
sidered due to an influence on 
the cardiac inhibitory nerves. 
It is noted, however, that 
shortly before death, in cases 
of opium poisoning, the pulse 
becomes feeble, rapid, and 
irregular. The stimulating 
action on the sympathetic 
nerves causes some contrac- 
tion of the smaller vessels to 
accompany the use of mode- 
rate doses of opium. 

III. Respiration and Tem- 
perature. — The breathing 
tends to become slow from 
the paralyzing influence of 
opium on the respiratory 
centre, and at the same time 
the secretion from the bron- 
chial tubes is lessened. 

The temperature at first 
rises a little, but finally falls 
when sweating is established. 



II. The subcutaneous in- 
jection of morphine has been 
advised by Dr. Clifford All- 
butt, in angina pectoris, pal- 
pitation, and various painful 
cardiac conditions. Its con- 
tracting influence in the small 
vessels explains the antiphlo- 
gistic effect of opium in cases 
of peritonitis and other in- 
flammatory conditions, as well 
as its power of checking coryza 
in its early stage. It also acts 
well as an astringent in some 
forms of hemorrhage, and 
more especially that from the 
lungs. 



III. Opium is the most 
soothing remedy for coughs 
of all kinds, but more espe- 
cially that of phthisis. It is a 
valuable aid in spasmodic 
asthma and the early stages 
of acute pneumonia, but in 
the later stages we must be- 
ware of its power of checking 
secretion, and in bronchitis it 
may do harm by slowing the 
respiratory movements, caus- 
ing sleep to interfere with the 
due emptying of the bronchial 



IV. Digestive and Secret- 
ing Organs 1. Nausea oc- 
casionally follows the use of 
opium, and constipation in- 
variably results from diminu- 



imperfect aeration of the 
blood and final suffocation. 

IV. 1. Opium is an excel- 
lent astringent in diarrhoea, 
dysentery ,s.ndJ3ritish cholera, 
often succeeding where other 
remedies fail, and for the 



OPIUM. 



397 



tion of the intestinal secre- 
tions, no less than arrest of 
the peristaltic movement of 
the canal. 



2. The salivary secretion 
is also diminished, causing 
dryness of the tongue. 

3. The urine is lessened 
in quantity, but opinions differ 
as to the effect produced on 
its solid ingredients. 



4. The biliary secretion is 
checked. 

5. The secretion of the 
skin is increased, perspiration 
usually resulting, and we 
may say generally that opium 
checks all secretions but that 
of the skin. 



Elimination takes place 
by the breath, sweat, urine, 
milk, etc. 



relief of pain and tenesmus 
nothing is better than the 
enema of the Pharmacopoeia 

(Br.). In the diarrhoza of 
ulcerative processes, such as 
typhoid and phthisis, and the 
later stages of dysentery, it is 
truly invaluable. 



3. Opium is of great ser- 
vice in some cases of diabetes, 
checking thecravingappetite, 
and lessening the secretion of 
sugar. 

We must beware of its use, 
however, in advanced cases 
of renal disease, where it acts 
injuriously by checking secre- 
tion and encouraging the re- 
tention of urea in the blood. 



5. Opium in some forms, 
and more especially Dover's 
powder, acts as an efficient 
diaphoretic, but, curiously, it 
has an opposite effect in 
phthisis, where it has been 
used with success to check 
night-sweats. 

We must remember this 
elimination by the milk, in 
prescribing opium to suckling 
mothers. 



Cautions, and Modes of Administration. 

In giving opium, we must remember that human beings, 
like the lower animals, are diversely susceptible to its in- 
fluence. Thus ducks and pigeons can swallow large quanti- 
ties with impunity, whilst the horse and the dog rapidly fall 
34 



398 opium. 

under its influence; and although we can hardly lay down 
any general rules to guide us in practice, we shall find that 
some persons can take very heavy doses, whilst others are 
poisonously affected with unexpected rapidity. We must 
specially remember that children always bear opium badly, 
one drop of laudanum having proved fatal to an infant ; that 
anaemic persons also are said by Traube to be readily sus- 
ceptible. To guard ourselves as far as possible from risk, 
we shall do well to begin with a moderate dose, and in- 
variably to ask our patient whether he has ever taken it 
before. 

As the system seems rapidly to accustom itself to the use 
of opium, we require gradually to increase the dose, and 
so completely do persons habituate themselves to the plea- 
surable sensations derived that they willingly brave the 
resulting languor and digestive disturbance, and take it in 
enormous quantities. De Quincey used to take as much as 
320 grains daily, and from half a pint to a pint of laudanum 
is by no means an uncommon daily allowance. Although 
the Turks, Chinese, and Hindoo races are the principal vic- 
tims of this habit, much opium is also consumed in this way 
in some parts of England, and moderate opium-eaters abound 
in all ranks of society. We must therefore be very careful 
to warn our patients from time to time of the absorbing na- 
ture of this practice, and of its enervating effects on mind 
and body ; and although it seems evident that good health is 
not altogether incompatible with moderate opium-eating, and 
that its use by smoking is far more deleterious, still there is 
abundant evidence of the general lowering tendency of the 
habitual use of this drug as an act of mere self-indulgence. 

As regards the various pharmaceutical preparations of 
opium, when we wish to produce sleep we generally pre- 
scribe the tincture in a medium dose of tti,xx, the pill, or 
the extract (gr. j) ; whereas, if we merely wish to relieve 
pain, smaller doses may prove sufficient. 

The astringent action is best secured by small doses, 
which bring the stimulant properties of the drug into play; 
and an incipient coryza may often be checked by 5 or 10 
minims of laudanum taken at bed-time. 

For diaphoretic purposes the combination with ipecacuanha, 
as in Dover's powder (pulvis ipecacuanha? et opii, U. S.), is 
of service ; and for the relief of diarrhoea we also call to our 
aid the astringent properties of chalk and kino, as in the 



opium. 309 

pulvis eretrc aromaticus cum opio (Br.) (gr. xx to xl), an.l 
the pulvis kino compositus (Br.) (gr. xx) ; or the enema 
opii (Br.) may be soothing likewise in this condition, and 
allaying, by nervous sympathy, various painful conditions of 
the uterus and bladder. 

As an adjunct to cough mixtures, and as forming their 
really effective ingredient, we most conveniently prescribe 
opium under the form either of the tinctura camphone com- 
posita (nv,xxad 5j) or of the tinctura opii ammoniata (Br.) 
(ttlxx ad 5j)j as i Q Prof. Christison's well-known for- 
mula : — 

I£. Syrupi scillse gij ; 

Aq. menth. pip. §ij ; 

Tinctura? opii ammoniata? gss , 

Tinctura; lavandula? composite §ss ; 

Syrupi §j. M. 

Dose, ijss ter die. 

In diabetes we must push the drug boldly, to the extent 
even of from fi to 8 grains a day. 

Alkaloids of Opium. 

The many-sided actions of opium which we have just de- 
scribed are due to its complex constitution and to the large 
number of alkaloids which it contains. Of these, morphine 
is by far the most generally used, and in the form either of 
the hydrochlorate or the acetate, but more especially of the 
former, it. has in very considerable measure superseded the 
crude drug on which we were formerly obliged to depend. 
Its principal differences from opium are as follows : — 

It is less astringent and antiphlogistic, and, by interfering 
less with secretion, its use is not attended by so much head- 
ache, constipation and dryness of tongue. It is more directly 
narcotic and anodyne, and is therefore a more convenient 
remedy when we wish merely to promote sleep or to re- 
lieve pain. 

Its bulk is smaller than that of opium, and it is devoid 
of smell. 

The action of the heart becomes slower, and the arterial 
tension is raised. 

The respiration may become irregular from a depressing 
action on the vagi. 

The functions of the spinal cord are stimulated, and hence 
we occasionally meet with restlessness and muscular twitch- 



400 OPIUM. 

ings, which in some of the lower animals run on into true 
convulsions. 

Irritability of the bladder is often observed, and trouble- 
some itching of the skin, depending, in some cases, on the 
development of a minute papular or vesicular eruption. 
Some years ago a favorite mode of using morphine was by 
what is known as the endermic method, in which the powder 
was sprinkled over the raw surface of a blister ; but this has 
now been almost entirely superseded by the hypodermic 
syringe. This ingenious little instrument enables us to inject 
a small quantity of morphine in solution beneath the skin, 
and the relief to suffering is usually immediate, and some- 
times permanent. It matters little whether or no we introduce 
the remedy into the immediate neighborhood of the painful 
spot, our only caution being to avoid the vicinity of large 
bloodvessels or nerves, and to plunge the nozzle of the 
syringe fairly through the skin into the adjacent cellular 
substance. Some smarting usually follows the entrance of 
the fluid, and inflammation and abscess may occasionally be 
produced; but these accidents are rare, and the sting of the 
primary puncture may readily be obviated by benumbing the 
skin with ether spray. These injections are now very 
largely practised for the relief of pain, and more especially 
in facial neuralgia, sciatica, lumbago, in the passage of 
biliary or renal calculi, in cancer, and a vast range of dis- 
eases in which acute suffering is the main symptom, we are 
enabled to give our patients temporary and sometimes per- 
manent relief. So great, indeed, is the popularity of this 
mode of treatment, that a new school of opium-eating, so to 
speak, has been formed, and morphine injections have un- 
fortunately been practised to a great extent as a mere devel- 
opment of self-indulgence. "We must, of course, be very 
careful not to give even the most casual or indirect encourage- 
ment to such disastrous habits. 

Some caution is always requisite in prescribing these in- 
jections for the first time, as not only severe sickness and 
vomiting have followed their use in many cases, but great 
prostration, with failure of the heart's action, and even death. 
We must therefore carefully watch our patient for some time 
after the completion of the little operation. We must never 
begin with a larger quantity than the sixth of a grain ; and 
we are told, on good authority, that the combination of ^of 
atropine to one part of morphine will effectually obviate all 



opium. 401 

risk of these unpleasant consequences. For injection we may 
use the injectio morphinae hypodermica, containing 1 gr. of 
the acetate in every 12 minims, remembering that morphine 
acts in this way three times more powerfully than when taken 
by the mouth. For internal use we may prescribe either 
salt in doses as from J gr. to 1 gr., remembering, however, the 
varying susceptibilities of different persons, and the fact that 
so small a quantity as half a grain has caused death ; or we 
shall find the liquor morphinre hydrochloratis or acetatis (Br.) 
containing half a grain to the drachm, a convenient prepara- 
tion. It is of the highest importance that all hypodermic 
solutions should be freshly prepared, as they very readily de- 
compose, and thus cause irritation. 

The B. P. has now added morpJiince sulphas and the liquor 
morphince bimeconatis, an excellent preparation, and often 
Avell borne by patients who cannot take morphine in other 
forms. Dose, 5 to 40 minims. The B. P. contains the in- 
jectio apomorphinai hydrochloratis, composed of gr. ij ad 
aquas cam ph. \\\. 

Many of the other alkaloids contained in opium are merely 
subjects for physiological curiosity. 

1. Codeina or codeia, however, is now frequently used, not 
for its narcotic properties, which are feeble and transient, 
but for an undoubted soothing influence which it exerts over 
various painful affections of the [stomach and] kidney. It is 
also an established remedy in diabetes, checking the secretion 
of sugar, and arresting, in some cases, the progress of the 
disease. Its great advantage over opium is, that it can be 
freely pushed without causing narcosis. We may give gr. 
^ to gr. ij thrice a day until drowsiness supervenes, or the 
sugar disappears, and from gr. x to gr. xv have been daily 
administered with benefit. [Fraser has shown, by a series 
of carefully conducted experiments, that codeine has no ad- 
vantages over the hydrochlorate of morphine, in diabetes, in 
doses usually of one grain a day, and the latter is only about 
one-third of the price of the former.] 

2. Narceine possesses only one-eighth of the narcotic prop- 
erties of morphine, and is never used in medicine. 

3. Crytopia is one-fourth as powerful as morphine, and, in 
addition to its hypnotic properties, it causes in the lo win- 
animals peculiar illusions of vision, with a tendency to con- 
vulsive action. It also is never used. 

34* 



402 ORIGANUM — PAREIRA. 

4. Thebaia is purely excitant, and in doses of 1 grain it 
causes tetanic spasms. 

5. Narcotina has no narcotic properties, but has some 
power as an antiperiodic. 

6. Papaverine is narcotic. 

7. Meconine is feebly narcotic. 

Apomorphine, which is prepared from morphine, is a 
powerful emetic, occasionally used by subcutaneous injection, 
in doses of Jg- gr. 



[ORIGANUM— ORIGANUM (WILD MARJORUM). 

Origanum vulgar e, Linne* (N. 0. Labiatm). 

Officinal Preparation, U. S. 

Vinum Aromatieum (see page 95). 

The oil of origanum (not officinal) is an aromatic stimu- 
lant. Origanum in infusion has been used as a diaphoretic 
and emmenagogue, and externally as a fomentation.] 



PAREIRA— PAREIRA (PAREIRA BRAVA). 

[ The root of Chondodendron Tomentosum, Ruiz et Pavon 
(N. 0. Menispermacece). 

Officinal Preparation, U. S. 

Extractum Pareirae Fluidum. Dose, f3ss-j (2. 
to 4. Gm.).] 

Constitutional Actions. 

Physiological. T'herapeutical. 

Digestive and Secreting Pareira is used in various 
Organs. — Pareira acts in chronic bladder- affections, 
some measure as a diuretic, but it seems to be very un- 
but its main influence is di- certain in its action, 
rected to the bladder, which 
it appears to stimulate and 
strengthen, improving the 
tone of its mucous lining, 
and lessening abnormal se- 
cretions. 



PUMPKIN SEED — SACCHARATED PEPSIN. 



403 



[PEPO— PUMPKIN SEED. 

The seed of Cucurbita Pepo, Linni (N. 0. Cucurbitaceoz) . 

Pumpkin-seeds are an efficient trenicide in doses of one or 
two ounces. The decorticated seeds, beaten into a paste 
with sugar or milk, are given in the morning fasting, fol- 
lowed, in an hour or two, by a dose of castor oil.] 



-SACCHARATED 



PEPSINUM SACCHARATUM- 
PEPSIN. 

[Pejisin, the digestive principle of the juice obtained from the mucous mem- 
brane of the stomach of the Hog, and mixed with powdered sugar of milk. ] 

Dose, gr. ij-xx (.12 to 1.30 Gm.). 

[Officinal Preparation, U. S. 

Liquor Pepsini (Sac. pepsin 40 parts, hydrochloric 
acid 12 parts, glycerine 400 parts, water to make 1000 parts). 
Dose, 3j-gj (4 to 32 Gm.)]. 

Internal Actions. 



Physiological. 

Pepsin is the most import- 
ant digestive element of the 
gastric juice, and more espe- 
cially reduces the albuminoid 
and proteinaceous constitu- 
ents of food to a fit state for 
absorption. 

Probably, as suggested by 
Gubler, pepsin acts, partly 
at least, by directly stimulat- 
ing the secreting function of 
the stomach mucous mem- 
brane. 

The ordinary pepsin wines 
rapidly become inert, because 
the alcohol does not prevent 
the ferment from changing, 
glycerin being the most ef- 
fective means of preserva- 
tion. The acid glycerin is 
undoubtedly the best fluid 



Therapeutical. 

There can be little doubt 
that many dyspeptic condi- 
tions are due to a deficiency 
of gastric juice, and attempts 
may be made to supply this 
by prescribing pepsin, prefer- 
ably in combination with di- 
lute hydrochloric acid. 

In atonic dyspepsia, in va- 
rious anaemic and cachectic 
conditions, in the diarrhoza 
of children, in some forms of 
spasmodic asthma, its use 
seems to be attended with 
good results; but we may 
well share Dr. "Wood's skep- 
ticism as to the possibility of 
materially aiding the diges- 
tion of food by the small 
doses usually prescribed. 

Pepsin has also been re- 



404 PETROLATUM. 

preparation. [When given commended as an addition 

in combination with acids, to nutritious enemata, so as 

the pepsin is much more ac- to insure some preliminary 

tive than in the form of pow- digestion of the injected food, 

der. An artificial gastric juice and the peptonized milk, 

thus made is of great service gruel, and beef-tea, prepared 

in weak digestion due to as recommended by Roberts, 

atony of the stomach. Strong of Manchester, with liquor 

solutions will digest blood pancreaticus, are very useful 

clots and false membranes in given cither by the mouth or 

cases of hemorrhage into the the rectum, 
bladder, and in diphtheria.] 



[PETROLATUM—PETROLATUM (PETROLEUM 
OINTMENT). 

A semi-solid substance consisting of hydrocarbons, chiefly of the marsh- 
gas series [ C ]6 H M , etc. ] obtained by distilling off the lighter and more vol- 
atile portions from American petroleum, and purifying the residue. Melt- 
ing point about 40° to 51° C. (104° to 125° F.), the first constituting the 
softer, and the second the firmer variety. 

To a limited extent in the south of Europe, but in great 
quantity in the United States, petroleum is found either ooz- 
ing from the ground or obtained by drilling wells. Crude 
oil, which is of a dark color of the consistence of molasses, 
but decidedly fluorescent, yields, by rectification, a number 
of hydro-carbonaceous compounds, some of which have suf- 
ficient density to be used as ointments (cosmoline, vaseline, 
etc.). On account of their property of resisting oxidation, 
never becoming rancid in the hottest weather, unguentum 
petrolei, or petrolatum, is now being largely employed as a 
substitute for lard as the basis of ointments. Coal oil has 
been used externally as an ointment for painful rheumatic 
joints and in the treatment of scabies with good results. The 
combination of petrolatum with carbolic acid (5 per cent.), 
on account of local anaesthetic effects of the latter, makes a 
very useful embrocation for chilblains. Cosmoline is an ex- 
cellent unirritating dressing for burns and scalds, or excoria- 
tions and wounds, and is much used in hospitals. Internally, 
crude oil has been given in the case of tapeworm, also in whoop- 
ing-cough and bronchitis, but is rarely used by the medical 
profession. In excessive doses it produces oppression, giddi- 
ness, palpitation, faintness, and headache, but no tendency 
to stupor, or even sleep. In one case frightful convulsions 



PHOSPHORUS. 405 

appeared, in another death occurred with symptoms of gastro- 
enteritis on the twentieth day after it had been taken (Stille). 
The urine, after taking the oil, has a peculiar odor, and it 
may have a special action upon the kidneys. 

Ehigolene, one of the light products, has been used to pro- 
duce cold with the hand-spray as a substitute for ether ; in 
chorea, when it is applied along the spine, and as a local 
anaesthetic for some surgical operations. Its garlicky odor 
and explosiveness are the principal objections to its use.] 

Vaseline is a soothing and agreeable application in skin 
diseases, but, wanting solidity, is best used in combination 
with white wax or other ointments. 

Kaposi strongly recommends an ointment in eczema, made 
by dissolving and thoroughly incorporating by heat equal 
parts of vaseline and lead plaster, adding a little oil of ber- 
gamot. 

[Petrolatum melts at the temperature of the body ; it is 
odorless, and as it does not become rancid like ordinary fats, 
it is a good basis for ointments. It also may be obtained 
under the trade names of cosmoline, or vaseline cerate, fluid 
cosmoline, and in various combinations. It is an excellent 
dressing for burns. When Petrolatum is prescribed or or- 
dered, without specifying its melting-point, the low melting 
variety, which liquefies at about 40° C. (104° F.), is to be 
dispensed.] 



PHOSPHORUS— PHOSPHORUS. 

[Officinal Preparations, U. S. 

Aeidum Phosphoricum (see Phosphoric Acid). 

Oleum Phosphoratum (1 per cent.). Dose, ny*- 
iij (.06 to 20 Gin.). 

Pilulae Phosphori (each T ^ grain). 

Zinci Phosphidum. Dose, gr. ^~i\ (- 002 t0 - 005 
Gm.). 

Dose, in substance, gr. ^ to y 1 ^ (.001 to .005 Gm.).] 

Poisoning. 

The poisonous effects consist of intestinal irritation and 
cardiac syncope, and death from exhaustion, the post mortem 
disclosing fatty, and parenchymatous, degeneration of liver, 
muscles and tissues generally. The blood becomes black, 



406 



PHOSPHORUS. 



unduly liquid, and loaded with the products of tissue decom- 
position, such as uric acid, creatine, leucine, tyrosine, etc., 
this resulting from the ozonizing properties of the poison. 
The degenerative changes are probably due to the formation 
of fat from the albuminous constituents of the tissues them- 
selves, by increased tissue change, or diminished oxidation. 
One and a half grains have proved fatal. 

Antidotes. 

Sulphate of copper has been recommended as an antidote, 
and also turpentine, that is to say, the crude ozonized drug, 
best given in the form of gelatine capsules, and promptly ad- 
ministered, as it completely fails after twenty-four hours, 
about 5ij neutralizing each grain of phosphorus. 

There is no direct antidote, but turpentine is said to act 
as a prophylactic. [Old oil of turpentine is considered an 
antidote to phosphorus, followed by demulcents and evacu- 
ants. - Large draughts of water containing magnesia in 
suspension are especially useful.] Sulphate of copper is the 
best emetic to use. 



Constitutional Actions. 
Physiological. 

1. Its action on the ner- 
vous system is tonic and stim- 
ulant, repairing the waste of 
tissue. It is also useful, like 
arsenic, in certain obstinate 
forms of skin disease, as 
psoriasis, etc. 

Broadbent explains its tonic 
action by a change which it 



effects in the blood through a 
gradual influence on all 
growths in all the organs and 
tissues, and more especially 
on cell growth in the skin as 
it passes through it. 



Therapeutical. 

1. Phosphorus is therefore 
a valuable agent in nervous 
debility, where the brain is 
weakened by anxiety, worry, 
overwork, or sexual excesses, 
and where too great amount 
of phosphates is excreted by 
the urine ; and in neuralgia, 
which has been shown by 
Anstie to depend on a feeble 
state of nerve tissue. After 
considerable experience, how- 
ever, of the' drug in these 
conditions, I am strongly of 
opinion that no more over- 
rated remedy has ever been 
introduced into practice, that 
its action as a general tonic is 
most uncertain, and that in 



PHOSPHORUS. 



40? 



2. On the circulation it acts 
in the first place as a stimu- 
lant; the pulse rises and gains 
in fulness but not firmness, 
the face flushes, and eventu- 
ally signs of peripheric capil- 
lary expansion ensue, ending 
in free perspiration. In large 
doses, however, it depresses 
to a dangerous degree the 
heart's action. 

3. The temperature during 
the administration of phos- 
phorus at first rises slightly, 
next becomes secondarily low- 
ered by three or four degrees 
in consequence of the dilata- 
tion of the superficial capil- 
laries and resulting evapora- 
tion and radiation from the 
skin. 

4. On the urine phosphorus 
exerts the following influ- 
ence: Its quantity is in- 
creased, it becomes reddish, 
clouded with lithates, acquir- 
ing a violet smell, and, ac- 
cording to B. von Bauer, its 
proportion of urea is markedly 
increased. 

Hematuria results from a 
poisonous dose. 

5. On the intestinal secre- 
tion no effect is produced by 
small doses ; but it has been 
held by good authorities that 
phosphorus may interfere with 
digestion by preventing the 
action of the gastric juice on 
albuminoid materials. In the 



neuralgia it is greatly inferior 
to many other older and safer 
preparations. 

2. Its depressing action on 
the heart is a serious draw- 
back to its use, several fatal 
cases of cardiac syncope hav- 
ing been caused by moderate 
doses. 



5. Much discussion has 
arisen respecting the remedial 
powers of phosphorus in leu- 
cocythremia and in pernicious 
anaemia ; the evidence in its 
favor being principally de- 
rived from one successful case, 
and from the undoubted fact 



408 



PHOSPHORUS. 



event of a large quantity being 
taken, great and persistent 
irritation of the stomach and 
intestines results, causing 
pain, vomiting, and purging. 
Jaundice is also a symptom of 
its poisonous action, due in all 
probability to obstruction of 
the ducts, as the biliary acids 
may be detected in the urine. 
After death, fatty degenera- 
tion of the liver is generally 
found. 

6. To the skin, phosphorus 
acts in some measure as an 
irritant. 

Purpura may appear as a 
symptom of its poisonous 
action. 



7. Its effects on the osseous 
tissue are remarkable, as it 
has the property of causing 
necrosis of the jaw-bone, and 
this used to be common in 
lucifer-match makers. Some 
interesting experiments by 
Wegner have recently shown 
a marked influence of phos- 
phorus in promoting the 
formation of bone; for when 
given to growing animals the 
cancellous tissue was rapidly 
transformed into hard bone, 
and even in the case of those 
fully developed the medullary 
canal was sensibly diminished 
by its use. Also, in cases of 
artificial fracture, not only 
was the resulting repair more 



that the number of the red 
corpuscles is increased under 
its use in the ancemia of 
lymphadenoma. This is not, 
however, accompanied by any 
corresponding improvement 
in the local condition of the 
patient, and these seem to be 
precisely the cases in which 
the drug most suddenly and 
even fatally depresses the 
heart's action. 

6. On this account, and 
also because of its stimulat- 
ing the cutaneous circulation, 
phosphorus has been given in 
the eruptive fevers, such as 
scarlet fever, measles, etc., to 
develop an insufficiently de- 
veloped or prematurely faded 
eruption. 

7. The experiments of 
Wegner would indicate its use 
in rickets, but numerous trials 
which I have made have given 
only disappointing results, and 
shown its great inferiority to 
cod-liver oil. [In its pure 
form, preferably as oleum 
phosphoratum, Dr. A. Jacobi, 
of New York, has obtained 
very good results from phos- 
phorus in rickets, and advo- 
cates its use as a tissue-builder 
(Archives of Paediatrics, Aug. 
1888). Nothnagel and Ross- 
bach declare that in all severe 
cases of rickets it not only 
may be, but must be used. 
(Handbuch der Arzneimit- 
tellehre).~\ 



PHOSPHORUS. 409 

rapid, but the quantity of 
bone thrown out was far in 
excess of the usual amount. 

Phosphorus is given out from the system principally by the 
urine, the drug being oxidized in the system and eliminated as 
phosphates. 

CONTRA-INDICATIONS AND DISADVANTAGES. 

We must generally feel our way in prescribing phosphorus, 
and begin with small doses, for some persons are more sus- 
ceptible than others to its over-action. Sickness and diarrhoea 
occasionally follow its use, and Anstie records a case in which 
three or four -j^ gr. doses gave rise to long-continued epi- 
gastric pain. Nor must we forget its tendency to cause fatty 
degeneration of internal organs, this result being due to the 
formation of fat from their albuminous constituents by in- 
creased tissue-change and diminished oxidation. On the 
whole, we may sum up by saying that after ample trial phos- 
phorus has entirely disappointed the hopes of those who ar- 
gued from its physiological action to its therapeutical use, 
and that its drawbacks so largely counterbalance its advan- 
tages that it will probably soon disappear from ordinary 
practice. 

Mode of Administration and Dose. 

Much of our success, however, in giving phosphorus de- 
pends on the mode in which it is prescribed, and, as a general 
rule, capsules containing ^ grain are found to be a con- 
venient medium. It also goes well with cod-liver oil, but it 
is very difficult indeed to devise any liquid formula by which 
it is prevented from becoming rapidly inert by oxidation. 
Most of the pill-masses are useless from being made with 
insoluble materials which pass through the bowels unchanged. 
But Mr. Carteighe has furnished me with the following 
formula for soluble pills : — 

R. Phosphori gr. j ; .06 Grin. 

Carbonis bisulph. q. s. 

Saponis 

Pulv. glycyrrhizse, 
Pulv. guaiaci, aa 5ss ; 

M. Fiant pilulse xxx. 
These pills should be varnished to prevent oxidation. 
35 



410 PHYSOSTIGMA. 

[Objections against the use of phosphorus in substance 
arise from its insolubility in the intestinal fluids, and the 
danger of the local action in the stomach. The ethereal so- 
lution or tincture of phosphorus maybe given in combination 
with cod-liver oil, or, more acceptably, with the elixir of 
Calisaya bark; and phosphorized resin (4 per cent.) offers a 
convenient means of administration in pill form, one grain 
being equal to -^ s gr. of phosphorus.] 

The dose, speaking generally, is from ^ to ^L grain ; or 
we may give the phosphide of zinc, a very convenient and 
reliable preparation, in pills containing from y 1 ^ to J grain 
[or, as recommended by Hammond, in combination with 
nux vomica : — 

I£. Zinci pliospliid. g r - to5 

Ext. nucis vom. gr. 5 . 

M. ft. pil. 

This is especially valuable in neuralgia.'] • 



PHYSOSTIGMA— PHYSOSTIGMA (CALABAR 
BEAN). 

[The seed of Physostigma venenosum, Balfour (iV. 0. Legwninosce, 
Papilionaceoz) . 

The ordeal bean of Old Calabar. 

Officinal Preparations, U. S. 

Extractum Physostigmatis. Dose, gr. ^ to J (.01 
to .02 Gm.). 1 

Tinctura Physostigmatis (10 per cent.). Dose, 
ntxv-xl (1-2.60 Gm.). 

Physostigminse Salieylas. 2 Dose, gr. ^\ to ^ 
(.001 to .015 Gm.).] 

1 [Extract of physostigma lias been given in much larger doses, 
as much as four grains every hour having been administered in 
tetanus, and even larger doses employed. Care should be taken, 
however, with these unusual amounts.] 

2 [According to Pohl and Harnack, physostigma contains two 
active principles, eserine, opposed to strychnine, and calabarine, re- 
sembling strychnine, in its effects upon the spinal cord. Eserine 
is now known as physostigmine.] 



PHYSOSTIGMA. 



411 



Poisonous Action. 

Calabar bean in small doses destroys life by paralyzing 
the respiratory centre and causing suffocation ; but in larger 
doses it proves more speedily fatal by cardiac syncope. 

Antidotes. 

In addition to the general principles of treating this form 
of poisonous action, we have here two physiological remedies 
at command — (1) atropine which directly antagonizes the 
respiratory depression ; and possibly (2) strychnine which 
stimulates the cord. 



Local Actions. 



Physiological. 

"When applied to the sur- 
face of the body, Calabar bean 
exerts no special influence, 
but when introduced to the 
eye it causes very complete 
contraction of the pupil, the 
effect beginning in fifteen 
minutes, and lasting for about 
eight hours. This is attended 
by a little twitching of the 
lids, slight supra-orbital pain, 
dimness of vision, fall of in- 
traocular tension, spasm of 
accommodation, and myopia. 
The pupil contraction is held 
to be due to stimulation of 
the fibres of the third nerve 
supplying the iris. 



Therapeutical. 

Calabar bean is therefore 
of use in ophthalmic surgery, 
to counteract the dilating 
effect of belladonna, and to 
prevent prolapse of the iris in 
cases of corneal injury or 
ulceration. 

The most convenient way 
of using Calabar bean in oph- 
thalmic surgery is by making a 
two-grain solution of sulphate 
of eserine [physostigmine], 
and puttinga drop into the eye. 
This application is of service 
in strumous and phlyctenular 
ophthalmia and corneal ulce- 
ration, by limiting the access 
of light to the retina, and 
diminishing the reflex action, 
causing spasmodic contrac- 
tion of the lids. 



Constitutional Actions. 



I. On Nervous System. — 
1. The brain is quite unaf- 
fected, the mind remaining 



412 



PHYSOSTIGMA, 



clear almost to the last in 

cases of poisoning. 

2. The spinal cord, how- 
ever, is especially attacked, 
and to a diminution of its 
motor power is due the mus- 
cular enfeeblement and final 
paralysis which affect those 
brought fully under the in- 
fluence of this drug. A still 
more remarkable result, how- 
ever, is the total abolition of 
all reflex activity, the most 
energetic stimulation failing 
to elicit the slightest response. 



3. Although, in the first 
stage of Calabar bean action, 



2. The depressing action of 
Calabar bean on the reflex 
powers of the spinal cord led 
Fraser to propose it as a 
remedy for tetanus, and this 
mode of treatment has proved 
very satisfactory in alleviat- 
ing the symptoms and check- 
ing the course of this terrible 
disease [and successful results 
have been reported from its 
employment]. 1 It is of great 
importance that the drug 
should be early used and 
vigorously pusjied, as there is 
every reason ito believe that 
the cord is free from marked 
pathological changes during 
the first period of the disease. 

Calabar bean has been 
tried without success in cho- 
rea, epilepsy, and other ner- 
vous disorders ; but recently 
Dr. Crichton Browne has 
expressed his conviction, 
founded on the observation 
of a few cases, that it may 
prove useful in the general 
paralysis of the insane. And 
it has been employed, with al- 
leged success, in locomotor 
ataxia and writer's cramp. 

It has also been found to 
act as an effective antidote in 
strychnine-poisoning. 



1 [Case of Dr. Layton in New Orleans Med. and Surg. Journal 
for March, 1882, cured by sulphate of eserine ; see also Philada. 
Med. Times, April 8, 1882, p. 475.] 



PHYSOSTTGMA. 



413 



the motor nerves are unaf- 
fected, a secondary lessen- 
ing of their conductivity is 
noted, and, with reference 
to the sympathetic system, 
an early excitation is fol- 
lowed by secondary depres- 
sion. 

The contraction of the iris, 
noted above, which takes 
place equally on local or in- 
ternal administration, is con- 
sidered due to paralysis of 
the peripheral vaso-motor 
nerve-fibres, and to stimula- 
tion of the terminal filaments 
of the third nerve. 

II. Circulating A p p a- 

ratus Under small doses of 

Calabar bean, the heart's 
action becomes slower and 
stronger, and the arterial 
tension is notably increased ; 
but when the system is 
brought more fully under 
the poisonous influence of 
the drug, the cardiac pulsa- 
tions become feeble and 
irregular, and finally cease. 
These results are believed 
to be due to stimulation and 
subsequent exhaustion of the 
peripheral cardiac filaments 
of the vagi, and the primary 
contraction and subsequent 
relaxation of the arteries are 
explained in the same way. 

III. Respiration and Tem- 
perature. — The breathing 
usually becomes slow and 
irregular, and the tempera- 
ture falls a little. 

35* 



A few drops of a solu- 
tion of gr. 2 of sulphate of 
physostigmine, dropped into 
the eye every 15 minutes, 
have proved beneficial in 
acute glaucoma. 



414 PHYSOSTIGMA. 

IV. Secreting Organs IV. Calabar bean is an 

Calabar bean tends to cause hepatic stimulant, but only in 

vomiting, with violent and poisonous doses, so that this 

painful contraction of the side of its action has no prac- 

stomach and increased peri- tical application. Atropine 

staltic movement of the in- antagonizes this, as all the 

testines. other actions of the drug. 

Increase in the salivary 
and cutaneous secretion has 
also been observed. 

Poisonous Action. Cautions. Mode of 
Administration. 

Calabar bean in small doses destroys life by paralyzing 
the respiratory centre and causing suffocation, but in 
larger quantity it proves more speedily fatal by cardiac 
syncope. 

Caution is of course necessary in dealing with so poison- 
ous a substance as this. It is seldom used internally, for 
in tetanus the functions of the stomach are suspended in 
great measure, and drugs are probably only very partially 
absorbed. Subcutaneous injection is therefore our best 
method, and we use a solution of the extract (from J to J 
gr. or .01 to .02 Gm.), neutralizing its irritating acidity by 
the addition of a little soda. 

The alkaloid physostigmine or eserine is a convenient 
preparation and may be used hypodermically. [The sul- 
phate of physostigmine is ten times the strength of the ex- 
tract, but is more liable to decomposition. The salicylate 
has been adopted as the officinal salt on account of its 
stability. 

The following formula was used successfully in the case of 
traumatic tetanus by Dr. Layton : — 1 



ty. Eserinse sulpliatis 


gr- h\ 


03 


Grlycerini 


f 3U ; 


8 


Syrup, aurantii corticis 


f 5xiv ; 


56 


Aquae 


fgij ; 


G4 


Dose, one drachm. 







The glycerin was added to prevent changes in the eserine. 
In the case referred to (9 years of age) a teaspoonful was 
given at first every hour, afterwards it was reduced as the 

i [New Orleans Med. and Surg. Journ., March, 1882. J 



PHYTOLACCA BERRY — PICROTOXIN. 415 

symptoms ameliorated. During seven days of treatment 
the boy took three grains (.20 Gm.) in all, without any toxic 
effects of the remedy being noticed other than its influence 
in controlling the disease. 

The tincture of physostigma is recommended as a useful 
preparation of this remedy.] 



[PHYTOLACCA BACCA— PHYTOLACCA BERRY 
(POKEBERRY). 

The fruit of Phytolacca decandra, Linn4 (2V. 0. Phytolaccaceoz) . 



PHYTOLACCA RADIX—PHYTOLACCA ROOT. 

The root of Phytolacca decandra, Linne* (2V. O. Phytolaccacece) . 

Phytolacca has been used as an alterative in syphilis, 
rheumatism, scrofula and chronic skin diseases. Although 
emetic and cathartic in doses of 15 to 30 grains (1-2 Gm.), 
it is not used for emptying the stomach or bowels, on account 
of the slowness of* its action. The dose as an alterative is 
gr. j-v (.06 to 32 Gm.).] 



PICROTOXINUM-— PICROTOXIN. 

A neutral principle prepared from the seeds of Anamirta paniadata, 
Colebrooke (N. 0. Menispermaceaz). 

Dose, gr. F "L to & (.001 to .003 Gm.). 

The active principles of cocculus Indicus are (in the 
pericarp) menispermia, and paramenispermia, hypo-picrotoxic 
acid, resin, fat, and gum, and (in the seed) picrotoxin and 
anamirtin, or cocculin. 

Treatment of Poisoning. 

Empty the stomach, bowels and bladder, give stimulants, 
ammonia or ether by inhalation ; and administer bromide of 
potassium.] 



416 



PILULE.. 



Physiological Effects. 

Cocculus indicus is poison- 
ous to lower forms of animal 
and vegetable life. 

It is fraudulently added to 
malt liquors to stop fermen- 
tation, and increase the bitter 
taste. 

In man gastro-intestinal 
irritation, congestion of brain, 
strabismus, vomiting, col- 
lapse, and great depression 
of the functions of the spinal 
cord. Picrotoxin differs from 
strychnine in producing alter- 
nate clonic and tonic convul- 
sions, but does not exalt the 
functions of the spinal cord as 
strychnine does. 

It is asserted that, in 
medicinal doses, picrotoxin 
acts like a bitter upon the 
stomach. Upon the spinal 
cord it acts like the combina- 
tion of strychnine with bella- 
donna. It also affects the 
cerebral functions, producing 
stupefaction and delirium ; 
in dogs convulsions are pro- 
duced. 



Therapeutical Effects. 

A solution or ointment of 
cocculus indicus is used to 
destroy lice. 



It is applicable to states of 
the stomach characterized by 
depression, and in paralytic 
conditions of the bowel ; and 
to certain cases of epilepsy, 
in which there is anaemia and 
feebleness. In paralysis it is 
less useful than strychnine. 
In chorea, in tremors of alco- 
holism, and similar nervous 
functional disorders, picro- 
toxin may be efficient. Mur- 
rell and Da Costa recommend 
it also in the treatment of 
night-sweats. 

As it has a special effect 
upon the alimentary tract, 
cocculus indicus may be used 
as a bitter tonic in cases of 
constipation due to torpor of 
the intestinal walls and in 
certain cases of indigestion. 



[Pilulae. 



The officinal Pills are : 

Pilulae Aloes 

" " et Asafcetidae 

" " et Ferri 

" " et Mastiches 

" " et Myrrhae 

" Antimonii Compositae 

" Asafcetidse 

" Catliarticse Compositae 



Pilulae Ferri Compositae 

" Ferri Iodidi 

" Gralbani Compositae 

" Opii 

" Phosphori 

" Rnei 

" Rhei Compositae 



PIMENTA — PIPERINE. 417 

Three Pill-masses are officinal : Massa Copaibae, Massa 
Ferri Carbonatis, and Massa Hydrargyri. 



[PIMENTA—PIMENTA (ALLSPICE). 

The nearly ripe fruit of Eugenia Pimenta, De Candolle 
(N. 0. Myrtacece). 

Officinal Preparation. 

Oleum Pimentae. Dose, gtt. iij-vj (.20 to .40 Gm.). 

Pimento is a warm, aromatic stimulant, but is more used 
as a condiment than as a medicine. As a carminative, the 
dose is from 10 to 40 grains (.65 to 2.65 Gm.). It enters 
into Spiritus Myrcise, and Spiritus Ammoniae Aromaticus.J 



PIPER— BLACK PEPPER. 

[ The unripe fruit of Piper nigrum, Linne' (2V. 0. Piperacece). 

PIPERINA—PJPERINE. 

A proximate principle of feebly alkaloidal power prepared from pepper 
and occurring also in other plants of the Nat. Ord. Piperaceoz. 

Dose, gr. j-x (.065 to .65 Gm.). 

Officinal Preparation. 

Oleo-resina Piperis. Dose, ttij (.06 Gm.).] 

Pepper is an acrid stimulant, acting more especially on 
mucous membranes, and hence, as a condiment, it is sup- 
posed to excite the secretion of the gastric juice. In former 
years it also acquired some reputation as a remedy for 
haemorrhoids. [Piperin is sometimes added to antiperiodie 
pills, and it is certainly active, although it has been stated 
that it owes its effects to an impurity, the active oil of 
pepper.] 



41 



PILOCARPUS. 



PILOCARPUS—PILOCARPUS (JABORANDI). 

The leaflets of Pilocarpus Pennatifolius, Linn£ (N. 0. Rutacece, 
Xanthoxylece) . 

Dose of the drug, gr. x to 5j (-65 to 4. Gm.). 

Officinal Preparations. 

Extraetum Pilocarpi Fluidum. Dose, n^x-lx 
(.65 to 2.60 Gm.). 

Pilocarpine Hydroehloras. Dose, gr. t l to J (.050 
to .02 Gm.).] 

Constitutional Action. 



Physiological. 

Within ten or twelve min- 
utes after jaborandi has been 
taken, the face flushes deeply, 
and profuse perspiration fol- 
lows, accompanied by a great 
increase of salivary secretion, 
terminating in from two to 
four hours. The loss of fluid 
thus produced is very con- 
siderable, and the sweat has 
been proved to contain a 
large excess of urea. This 
action on the skin is consid- 
ered due to vaso-motor para- 
lysis and consequent dilata- 
tion of the cutaneous arteri- 
oles, and thesialagogue effects 
of the drug are attributed to 
stimulation of the periphery 
of the nerves supplied to the 
salivary glands. Jaborandi 
increases somewhat the action 
of the heart ; and contraction 
of the pupil, with impaired 
accommodative power, has 
been noted to attend its use. 



Therapeutical. 

The powerful diaphoretic 
action of jaborandi, no less 
than its power in aiding the 
elimination of urea, would 
seem to suggest its use in va- 
rious chronic kidney-diseases 
[Bright's disease], as well as 
febrile conditions. But its 
action is too short, sharp, and 
sudden, and too much depres- 
sion and inconvenience are 
produced, to render us very 
hopeful of its ultimate success 
in practice, lnurcemia pilo- 
carpine may be given hypo- 
dermically.] 

It has been prescribed in 
diabetes insipidus, and for 
the purpose of augmenting 
the secretion of milk. 



PILOCARPUS. 419 

Atropine and muscarine ap- 
pear to be in many respects 
an exact physiological anti- 
dote to jaborandi. 

[Mode of Administration and Dose. 

The infusion of the powdered leaves is a good method of 
exhibiting the drug. A drachm should be steeped in half a 
pint of hot water, and when sufficiently cool stirred up and 
one-half the quantity drunk, half an hour later the remainder 
should be taken, without straining the infusion. This is 
generally sufficient to cause profuse sweating within an hour. 
Ptyalism is less constant in its occurrence. Experience, 
however, is in favor of using some of the pharmaceutical 
preparations in preference to the crude drug, as being more 
reliable and agreeable. 

The fluid extract of jaborandi is now largely used, the 
full dose being a fluidrachm, representing a drachm of the 
leaves. An elixir is also made by some pharmacists, con- 
taining the virtues of one drachm in six fluidrachms.] 

[The alkaloid of Jaborandi, possessing both the diapho- 
retic and sialagogue properties of the drug, is officinal under 
the name of 



Pilocarpine Hydroehloras — Hydroohlorate 
of Pilocarpine (C n H 16 N 2 2 HCl ; 244.4). 

Constitutional Effects. 

Physiological Effects. Therapeutic Uses. 

Dr. Popow {St. Petersb. From some comparative 

Med. Woch., August 4), re- trials which he has made with 

porting upon the results de- the internal administration 

rived from the hypodermic of pilocarpine, Dr. Cursch- 

injection of pilocarpine in men mann believes that the infre- 

in health and suffering from quency with which it causes 

fever, and in experiments vomiting, as compared with 

upon animals made in Prof, jaborandi, is principally due 

Suschtschinsky's laboratory, to its being used hypoder- 

comes to the following con- mically, and thereby avoid- 

clusions : — nig direct irritation of the 



420 



PILOCARPUS. 



1. Pilocarpine produces the 
vsame effect as an infusion of 
the leaves of jaborandi. 

2. An injection of from 
gr. £ to £ (.01 to .02 Gm.) 
induces abundant sweating, 
without causing the unpleas- 
ant effects (giddiness, vomit- 
ing, cephalalgia) produced 
by jaborandi, and is, there- 
fore, better suited for thera- 
peutical employment. 

3. The temperature dimin- 
ishes without any prior ex- 
altation, from one hour and 
a half to four hours, and 
reaches its minimum soon 
after the cessation of the 
sweating. 

4. The increased excretion 
of saliva is observed alike in 
the healthy and the sick, 
after doses of from gr. ^ to J 
(.01 to .015 Gm.). Sweat- 
ing only occurs in such doses 
in the healthy ; fever pa- 
tients, e. g., typhus, requiring 
gr. i (.02 Gm.). 

5. The quickening of the 
heart's action produced by 
the pilocarpine continues a 
pretty long time after small 
doses, but when large ones 
are employed, this is soon 
replaced by retardation. 

6. On the direct introduc- 
tion of pilocarpine into the 
veins a retardation of the 
heart's action takes place 
suddenly without any prior 
acceleration. 

7. Doses not exceeding 
gr. ^ (.03 Gm.) do not exert 



stomach. Some persons, es- 
pecially those who have been 
weakened by prior disease, 
complain of a sense of debi- 
lity, but this usually soon 
passes off; but in others a 
complete state of collapse is 
produced, which may or may 
not be connected with prior 
vomiting. The possibility of 
this occurrence must always 
be borne in mind. It is de- 
pendent upon the amount of 
the dose and the susceptibi- 
lity of the individual. It is 
oftenest met with in women, 
and in those whose strength 
has been greatly reduced ; 
and when the patient's con- 
stitution is not known, the 
first dose of the medicine 
should not exceed gr. ^ (.02 
Gm.), while its effect should 
be watched for a quarter or 
half an hour. As far as the 
trials have gone, pilocarpine 
does not seem to act danger- 
ously on the subjects of heart- 
disease, and, indeed, can be 
employed when no other dia- 
phoretic procedure, for so 
long a period, would be ven- 
tured upon. Indeed, as a 
therapeutical agent for the 
production of diaphoresis, it 
is superior to any other me- 
thod in use, being more 
easily employed, while its 
action is more certain and 
more complete, without being 
more or even as dangerous 
as most of them. Its supe- 
riority over the various 



PILOCARPUS, 



421 



any particular effect on the 
alimentary canal ; but large 
doses, gr. f to gr. jss (.05 to 
.10 Gm.), induce purging, or 
even bloody stools, with in- 
testinal movements and the 
development of gases. 

The quantity of urine and 
the amount of urea are both 
increased during the twenty- 
four hours succeeding its ad- 
ministration. 1 

It is uncertain whether 
jaborandi exercises any direct 
effect upon the heart. 



sweating-baths in ascites, hy- 
drothorax, asthma, etc., is 
most marked. It is true 
that diaphoretic treatment is 
thought less of than formerly ; 
but in several cases the diffi- 
culty of its application, rather 
than its inefficiency, is the 
cause of its not being resorted 
to. Speaking from his own 
experience, Dr. Curschmann 
has found the pilocarpi n very 
useful in oedema, in dropsy 
of the cavities from heart or 
lung disease, and in chronic 
nephritis, etc., and that after 
diuretic, drastic, and other 
means have failed. He be- 
lieves that a large field for 
its employment may be found 
in pleurisy accompanied by 
serious exudations, both in 
promoting the absorption of 
this, and in preventing its re- 
accumulation after paracen- 
tesis. It is evidently indi- 
cated in chronic rheumatic 
affections, at least so far as 
these are amenable to dia- 
phoretic treatment, and in 
some chronic skin affections, 
its use has been attended with 
considerable success. 

"Da Costa has shown that in acute erysipelas pilocarpine, or 
the fluid extract of jaborandi, exerts remarkable influence in 
cutting short the inflammation. Prof. Demme 2 gives, in 
dropsical affections of children, doses of gr. T ^ to ^ (.005 to 
.02 Gm.) of pilocarpine, which he regards as an efficacious 
diaphoretic and sialagogue in the treatment of certain 



1 [Drs. Tyson and Bruen, Am. Journ. Med. Sciences for July 1, 
1887.] 

2 [Med. Exam., July, 1878.] 

S6 



422 BURGUNDY PITCH — CANADA PITCH. 

diseases of children, and in appropriate doses it is well borne 
by the youngest patients- Unpleasant symptoms are of very 
rare occurrence, and can . probably be altogether prevented 
by administering small doses of brandy before the injection. 
The cases for which pilocarpine is especially suitable are 
the parenchymatous inflammations of the kidneys with 
dropsy, following scarlatina and diphtheria. In the majority 
of cases the flow of urine is decidedly increased, while the 
quantity of blood and albumen in the urine is diminished 
rather than augmented.] 



PIX BURGUNDICA— BURGUNDY PITCH. 

[ The prepared resinous exudation of Abies excelsa, De Candolle 
(N. 0. Coniferce). 

Officinal Preparations. 

Emplastrum Pieis Burgundieae. 
Emplastrum Pieis cum Cantharide. 

Enters into Emplastrum Ferri, Emp. Galbani, Emplas- 
trum Opii.J 

Pitch is used externally in the form of plaster. 



[PIX CANADENSIS— CANADA PITCH (HEM- 
LOCK PITCH). 

The prepared resinous exudation of Abies Canadensis, Michaux 
(N. 0. Conferee). 

Officinal Preparation. 

Emplastrum Pieis Canadensis. 

Used only in the form of the plaster. The oil of the 
Abies, or Pinus Canadensis, or Hemlock Spruce (oil of 
spruce, oil of hemlock), has been given to produce abortion. 
A fluid extract of the bark (Ext. Pinus. Canadensis fluid.), 
not officinal, is largely used as an astringent for gargles, va- 
ginal douches, etc.] 



TAR. 



423 



PIX LIQUI DA—TAR. 

[ An empyreumatic oleoresin obtained by the destructive distillation of the 
wood of Pinus palustris, Miller, and of other species of Pinus (N. 0. 
Coniferaz) . 

Officinal Preparations, U. S. 

Syrupus Picis Liquidae (6 percent.). Dose, f 3j-iv 
(4. to 16. Gm.). 

Unguentum Pieis Liquidae (Tar and suet, each 
50 parts).] 

External Actions. 



Physiological. 

Tar acts as a stimulant to 
the skin, and is apt to pro- 
duce an irritable papular 
eruption. It is rapidly ab- 
sorbed, and if allowed to re- 
main in contact with the 
surface of the body, or if 
applied over an extensive 
cutaneous area, feverish 
symptoms ensue, with an 
abundant discharge of black- 
ish urine, smelling strongly 
of tar. 



Therapeutical. 

Tar is an excellent appli- 
cation in cases of chronic 
scaly skin diseases, as psori- 
asis. 

To lessen the risk of ex- 
citing an undue amount of 
irritation, it is well to wash 
the skin perfectly clean be- 
fore renewing the applica- 
tion, and it is important to 
rub in the ointment thor- 
oughly until it nearly disap- 
pears. 



Internal Actions. 



Tar seems to have a stimu- 
lating action on mucous mem- 
branes when taken internally. 
[Tar contains a certain pro- 
portion of creasote, upon 
which some of its therapeutic 
effects depend.] 



The vapor of tar used to 
be a remedy of some repu- 
tation in chronic bronchitis, 
and recently Prof. Ringer has 
recommended two-grain pills, 
three times a day, as a most 
efficient remedy in winter- 
cough. The internal use of 
tar has also been praised by 
Dr. McCall Anderson in 
chronic skin diseases. [The 
syrup of tar is now officinal ; 



424 LEAD. 



it may be given in advanced 
bronchitis, in half-ounce 
doses.] 



GDI. 



ty. Picis liquid* 3ij 


8. 


Alcoholis giij 


12. 


Cola, et adde 




Aq. ammou. forti- 




oris T»\vj 


40. 


Glycerin i gvj 


24. 


Aq. destillatse §xij 


384. 


A good application in 


chronic eczema. (Anderson.) 



PLUMBUM— LEAD. 

[Officinal Preparations, U. S. 

Plumbi Oxidum (Litharge). Used in making 

Emplastrum Plumbi (Diachylon plaster), which enters 
into Emplastrum Asafoetidce, Emplastrum Ferri, Em- 
plastrum Galbani, Emplastrum Hydrargyri, Emplas- 
trum Opii, Emplastrum Resinoe, Emplastrum Arnicae, 
Emplastrum Belladonnas, Emplastrum Saponis. 

Unguentum Diachylon (Lead plaster 60, olive oil 
39, ol. lavender 1). 

Liquor Plumbi Subacetatis (Goulard's extract), 
(about 25 per cent, of subacetate of lead). 
Liq. Plumbi Subacetatis Dilutus (lead water), (3 per cent. 

of preceding). 
Ceratum Plumbi Subacetatis (Goulard's cerate), (20 to 

80 of camphor cerate). 
Linimentum Plumbi Subacetatis (40 to 60 cotton-seed 
oil). 

Plumbi Aeetas (Sugar of lead). Dose, gr. i-v (.65 
to .30 Gm.). 

Plumbi Carbonas. 

Unguentum Plumbi Carbonatis (10 per cent.). 

Plumbi Nitras (used as a disinfectant — Ledoyen's so- 
lution). Dose, internally g,r. | to | (.015 to .036 
Gm.). 

Plumbi Iodidum. Dose, gr. T \ to \ (.005 to .015 
Gm.). 
Unguentum Plumbi Iodidi (10 per cent.).] 



LEAD. 425 



Poisonous Effects. 

The first sign of chronic lead-poisoning is a bluish line 
running along the free margin of the gums [especially 
around the incisor teeth, upper and lower], composed of mi- 
nute dots, and depending on the actual deposition of lead in 
the mucous membrane. To this succeed colic, wrist-drop, 
and the other symptoms mentioned below, the post mortem 
disclosing chronic catarrh of the stomach and intestines, 
with the deposition of the metal in the bones, liver, kidney, 
brain, nervous and muscular fibres. 

Chronic lead-poisoning has occasionally resulted from 
adulterated cider or from water, and indeed in a variety of 
ways, but it is most common in painters, who are brought 
much in contact with the carbonate in the practice of their 
business. 

Antidotes and Treatment. 

[Sulphuric acid forms an insoluble compound with lead, 
and, therefore, the soluble sulphates (alum, Epsom salts) are 
chemical antidotes to lead poisoning ; they often are given 
combined with sulphate of morphine to relieve pain and relax 
spasm.] 

In poisoning by lead, we must give sulphate of magnesium, 
iodide of potassium, sulphur baths, and remove its after- 
effects by galvanism of the paralyzed muscles; but it is 
stated that sulphuric-acid lemonade, and a liberal indulgence 
in fatty articles of diet, may act in some degree as prophy- 
lactics. Common salt is said to be a good antidote because 
lead is eliminated from the kidneys as a chloride. 

Local Actions. 
Physiological. Therapeutical. 

The external action of lead Lead, in the form of sub- 
is partly sedative and partly acetate, is much used as lotion 
astringent. [All the prepara- for erysipelas, acute eczema, 
tions of lead are used exter- and various ulcerative condi- 
nally, but the acetate appears tions. 

to be the one best adapted It forms a good collyrium 

for internal use.] in the more superficial inflam- 

Squire praises a glycerate mations of the eye ; but we 
36* 



426 LEAD. 

of the subacetate of lead very must remember that its ten- 
highly in eczema. dency to deposition may cause 

a permanent white patch in 
corneal ulcers. 

The powder of nitrate of 
lead has been shown to be a 
good application in onychia 
maligna. 

[An improved process for making Hebra's diachylon oint- 
ment for skin diseases is given by Deringer (New Remedies, 
1880) as follows : Dissolve 200 Gm. of acetate of lead in one 
litre of distilled water, and 300 Gm. of white Castile soap in 
\\ litre of warm distilled water. Filter both solutions and 
mix them. The precipitate is washed with water, then freed 
as much as possible from moisture by kneading, and one 
part of it is melted with 1^ parts of best olive oil, on the 
warm bath. The mixture is then triturated in a mortar 
until it forms a fine white salve. — (Proc. Am. Pharm. As- 
soc, 1881, p. 63.)] 

Internal Action and Uses. 

1 . Brain and Nervous 
System. — When lead is given 
in poisonous doses, a curious 
train of nervous symptoms 
show themselves, beginning 
with violent neuralgic pains 
and giddiness, and running 
on into delirium, with epi- 
leptiform convulsions, and 
subsequent melancholia. Scle- 
rosis of the areolar tissue, 
with diminution of the ner- 
vous elements, has been found 
in certain of the sympathetic 
ganglia, but more especially 
the coeliac and cervical gan- 
glia. Atrophy of the optic 
nerve is an occasional, though 
rare, complication of lead- 
poisoning. 



LEAD. 



427 



2. Heart and Circulation. 
— During the action of lead, 
the heart becomes slow and 
the pulse smaller and harder, 
indicating a condition of con- 
traction and tension of the 
arterial system; and this is 
by some supposed to be due 
to a primary effect on the 
sympathetic, whilst others 
hold that lead has a direct 
influence over unstriped mus- 
cular fibre, and most power- 
fully over that which encir- 
cles the arteries. Lead tends 
to produce pallor by destroy- 
ing the red blood-corpuscles. 

3. Intestinal Tract. — A 
prominent symptom of chro- 
nic lead-poisoning is obsti- 
nate constipation depending 
probably on contraction of 
the small intestine, and asso- 
ciated with violent colicky 
pain around the umbilicus. 
The appetite at the same 
time becomes bad, the tongue 
loaded, and nausea and even 
vomiting are observed. Gas- 
tro-enteritis is generally one 
of the symptoms of acute 
poisoning. 

4. Urinary System Lead 

has the curious property of 
obstructing the elimination 
of uric acid from the blood 
through the kidneys, and may 
thus cause gout in painters 
and others who are exposed 
to the effects of the metal. 

5. Muscular.^— Lead causes 
violent pains in the muscles, 
with a peculiar form of para- 



2. This contractile influ- 
ence of lead over the smaller 
vessels explains its action in 
internal hemorrhage, as we 
know that hcemoptysis, more 
especially, may be very suc- 
cessfully treated by acetate of 
lead in doses of from -| gr. to 
3 grs. (.03 to .20 Gm.). 



3. Acetate of lead is an 
excellent astringent in diar- 
rhoea, more especially that of 
phthisis, and British [or spo- 
radic'] cholera. 

Dr. Thorowgood has ob- 
tained good results from lead 
in obstinate obstruction of the 
bowels. 



428 PODOPHYLLUM. 

lysis affecting the extensors 
of the forearms, and causing 
the well-known wrist-drop; 
and post mortem we find fatty- 
degeneration of the muscular 
structures. 

The contracting power of 
lead over unstriped muscular 
fibre probably explains the 
tendency to abortion noted 
during its poisonous influ- 
ence. 

Mode of Elimination. 

Lead is thrown out of the system by the urine, skin, 
bowels, and lacteal glands. 

Mode of Administration, etc. 

If we wish to administer lead internally, we generally 
prescribe either the acetate or pil. plumbi cum opii [Br.] 
(1 gr. of opium in 8), dose, 4 to 8 grs. (.25 to .50 Gm.). 

Externally we find the liquor plumbi subacetatis dilutus 
the most convenient form, but the glycerole and oleate are 
also good preparations, and the British Pharmacopoeia has 
lately added the glycerinum plumbi subacetatis to the list. 



PODOPHYLLUM—PODOPHYLLUM (MAY 
APPLE). 

[ The rhizome of and rootlets of Podophyllum peltatum (2V. 0. 
Berberidaceoz) . 

Officinal Preparations, U. S. 

Abstraetum Podophylli. Dose, gr. v-x (.30 to 
0.65 Gm.). 

Extraetum Podophylli. Dose, gr. v-x (.30 to .65 
Gm.). 

Extraetum Podophylli Fluidum. Dose, r^v-xx 
(.30 to 1.30 Gm.). 

Resina Podophylli (sometimes incorrectly called po- 
dopkyllin). Dose, gr. |— i (.007 to .015 Gm.).] 



PODOPHYLLUM. 



429 



Local Action. 

Podophyllum cannot penetrate the unbroken cuticle, but 
experiment has shown that it exerts its purgative influence 
when applied to a raw surface. 

Constitutional Actions. 



Physiological. 

The only marked physio- 
logical properly of this drug 
is that of irritating the duo- 
denum and causing a profuse 
flow of watery evacuations, 
largely mixed with bile. 
Some controversy has taken 
place as to whether podo- 
phyllum can be called a chola- 
gogue in virtue of any direct 
stimulation of the secreting 
structures of the liver, ex- 
perimental evidence seeming 
to show that it probably acted 
by contracting the gall- 
bladder, and thus favoring 
the expulsion of its contents, 
and by exciting the duodenum 
to sweep away the bile ef- 
fused into it by the hepatic 
ducts. The more recent ex- 
periments of Rutherford and 
Vignal, however, have re- 
instated podophyllum in its 
old position as a true stimu- 
lant of the biliary secretion, 
the mistake made by Ben- 
nett, who denied its chola- 
gogue action, having arisen 
from the administration of 
too large doses, and the con- 
sequent antagonism of the 
intestinal irritation to the 
hepatic secretion (vide Pur- 
gatives). 



Therapeutical. 

Podophyllum is a valuable 
remedy in jaundice and in 
the various forms of func- 
tional liver affection. It 
may be used in simple chronic 
constipation, in the constipa- 
tion of children attended with 
the painful and difficult eva- 
cuation of hard, dry feces, 
and in the opposite condition 
of diarrhoea with pale and 
frothy motions. 

In sick headache it also 
acts well. 

[Podophyllum is an effi- 
cient substitute for jalap, and 
may be used for all purposes 
for which the latter drug has 
been recommended.] 



430 POTASSIUM. 

Cautions and Mode of Administration. 

We must remember that podophyllum is an uncertain drug, 
acting well in some cases, very slightly in others, whilst in a 
third class it causes much discomfort and griping. It is ad- 
visable, therefore, always to begin with small doses, as J gr. 
or -J- gr., and to prescribe it in the form of a pill, combined 
with other ingredients which may restrain its irritating 
action. Thus: — 

I£. Resinse podophylli gr. ij ; or 12 Gm. 

Extracti belladormae ale. gr. iij ; " 20 " 

Pil. colocyntliidis compositse gr. xxxvi ; " 2 30 " M. 

Fiant pilulse duodecim, quaruin capiat unam omni nocte. 

Ringer recommends a very convenient way of prescribing 
podophyllum [resin] for children, by dissolving a grain in a 
drachm of rectified spirit, and giving five or six drops three 
or four times a day, on a lump of sugar, or painted on a bun. 



POTASSIUM. 

[Officinal Preparations, U. S. 

Potassa. Caustic Potassa. 

Liquor Potassas. Dose, n^x-xxx (.65 to 2. Gm.). 
Potassa cum Calce (equal parts) used as a caustic. 
Potassii Aeetas. Dose, gr. xx-3j (1.30 to 4. Gm.). 
Potassii Biehromas (as an alterative). Dose, gr. J 
(.01 Gm.). Rarely administered internally. 
(Used in preparing Sodii Valerianas.) 
Potassii Bitartras (Cream of Tartar). Dose, 3j- iv 
(4. to 16. Gm.). 
Antimonii et Potassii Tartras, Ferri et Potassii Tartras, 
Potassii et Sodii Tartras (Rochelle Salt), Potassii Tar- 
tras, Pulvis Jalapge Compositus. 
Potassii Bromidum. Dose, gr. xx-3j (1.30 to 4Gm.). 
Potassii Carbonas. Dose, gr. x-xxx (.65 to 2. Gm.). 
(Extractum Mistura Ferri Composita, Potassii Bicar- 
bonas, Potassa Sulphurata, and in making Chloro- 
formum Purificatum and Spiritus iEtheris Nitrosi, 
Unguentum Sulphuris Alkalinum ; also in making 
Potassii Bromidum and Cyanidum, and Mistura Potas- 
sii Citratis.) 



POTASSIUM. 431 

Potassii Bicarbonas. Dose, gr. x-3j (.65 to 4. Gm.). 
(Liquor Magnesii Citratis, Liquor Potassce, Liquor Potassii 
Arsenitis, Liquor Potassii Citratis, Mistura Potassii 
Citratis, Potassii Acetas, Potassii Citras.) 
Potassii Chloras. Dose, gr. v-xx (.30 to 1.30 Gm.). 

Trochisci Potassii Chloratis (aa gr. v). 
Potassii Citras. Dose, gr. x-xxx (.65 to 2. Gm.). 

Liquor Potassii Citras. Dose, f^ss (16. Gm.). 
Potassii Cyanidum. Dose, gr. T ^ to T \ (.005 Gm.). 
Potassii Ferroeyanidum. Dose, gr. x-xv (.65 to 1. 
Gm.). 
(Used in making Acidum Hydrocyanicum Dilutum, Ar- 
genti Cyanidum, Ferri Ferroeyanidum, Hydrargyri 
Cyanidum, and Potassii Cyanidum.) 
Potassii Hypophosphis. Dose, gr. x-xxx (.65 to 2. 
Gm.). 
Syrupus Hypophosphitum. (See Phosphorus.) 
Potassii Iodidum. Dose, gr. x-5j (.65 to 4. Gm.). 
(Ammonii Iodidum, Hydrargyri Iodidum Rubrum, Liquor 
Iodi Compositus, Plumbi Iodidum, Unguentum Iodi, 
Unguentum Potassii Iodidi (5j to Ij).) 
Potassii Nitras. Dose, gr. x-xv (.65 to 1. Gm.). 
Argenti Nitras Dilutus. 
Charta Potassii Nitratis. 
Potassii Permanganas. Dose, gr. j-v (.06 to .30 Gm.). 
Potassii Sulphas. Dose, gr. xx-3iv (1.30 to 16. Gm.). 
Potassii Sulphis. Dose, gr. xv-3j (1. to 4. Gm.). 
Potassii et Sodii Tartras (Rochelle Salt). Dose, ^ss-j 
(16. to 32. Gm.). 
(Pulvis EfFervescens Compositus. See page 133.) 
Potassii Tartras. Dose, 3j-gj (4. to 32. Gm.). 
Potassa Sulphurata. Dose, gr. ij-v (.12 to .30 Gm.). 

Poisoning. 

Caustic potassa is a corrosive mineral poison. The 
symptoms produced by it are an acrid, caustic, urinous taste 
in the mouth, a sensation of burning heat in the throat, 
nausea, and sometimes vomiting of bloody matters. The 
surface becomes cold and clammy ; the pulse quick and feeble ; 
and there is often hypercatharsis, and violent colicky pains. 

Morbid Appearances — Strong marks of inflammation in 
the alimentary canal, with softening, erosion of the mucous 



432 



POTASSIUM. 



coat, and, in some cases, perforation of the stomach. Death 
may ensue partly from depression of the heart, and partly 
from inflammation of stomach and intestines. 



Tests. 

The alkaline reaction. It precipitates silver nitrate in the 
form of a dark-colored oxide. Carbonic acid water causes 
no precipitate. A concentrated solution, acidulated with 
muriatic acid, affords a deep-yellow precipitate with platinum 
bichloride. A solution of tartaric acid causes a white preci- 
pitate of cream of tartar. 

Antidotes. 

Vinegar and the diluted vegetable acids ; to be followed 
by a free use of demulcents, or oleaginous mixtures.] 

Local Action. 



Physiological. 

Caustic potash is a most 
powerful escharotic, with- 
drawing water from the tis- 
sues, and thus destroying 
them. It has, however, the 
disadvantages of being very 
deliquescent, and this ten- 
dency to spread, beyond the 
part we wish to attack, has 
led to its practical abandon- 
ment as a local application. 



The solution of permanga- 
nate of potash (Condy's fluid) 
oxidizes and destroys many 
organic substances. 



Therapeutical. 

Caustic potash, either in 
sticks or combined with lime 
in the form of potassa cum 
calce, was formerly used in 
the treatment of various 
forms of ulceration, and for 
the production of issues, 
which barbarous relics of 
antiquity are now fortunate- 
ly discarded from practice. 
Liquor potassae has been re- 
commended to soften the 
great toe-nail and facilitate 
its removal when ingrowing ; 
and the bicarbonate of potash 
forms a good lotion in acute 
eczema, as an injection in 
leucorrhcea, and as an appli- 
cation to rheumatic joints. 

It is therefore antiseptic, 
and a good application to un- 
healthy ulceration. [Lacerda 
recommends the subcutaneous 



POTASSIUM. 



433 



injection of a strong solution 
in snake-bite, about n^xv be- 
ing thrown into each punc- 
ture made by the fangs of the 
serpent.] 



Internal Actions and Uses. 



Physiological. 

1. Brain and Nervous Sys- 
tem Potassium salts, and 

more especially the nitrate, 
when given in large doses, 
exert a paralyzing action on 
the spinal cord, producing 
great muscular weakness and 
finally abolition of reflex sen- 
sibility. 

2. Heart and Circulation. 
— Moderate doses of the ni- 
trate raise the arterial tension 
and slow the heart's action, 
and if the drug is further 
pushed, the pulsations be- 
come weaker, still slower, 
and finally irregular, before 
the total arrest of movement 
supervenes. Coagulation of 
the fibrine is prevented, and 
the red corpuscles are re- 
strained in their functions of 
oxygenation. Chlorate of po- 
tassium in large doses (gr. cl. 
in 24 hours) causes vomiting, 
haematemesis, delirium, icte- 
rus, and coma, the urine being 
of a chocolate color, and full 
of disintegrated blood-corpus- 
cles. 

Potassium salts cause the 

blood, and secondarily the 

urine, to become alkaline, and 

any excess of uric acid may 

3Y 



Therapeutical. 



2. This has been supposed 
to explain the beneficial action 
of potash in acute rheuma- 
tism, which is held to depend 
on an excess of uric [lactic ?] 
acid. Much controversy has 
taken place with reference to 
the alkaline treatment of this 
disease, but I am decidedly of 
opinion that if large doses of 
bicarbonate of potassium do 
not shorten its duration, they 
relieve symptoms, and lessen 
the tendency to cardiac com- 
plications. Potash acts well 
also in gout and chronic rheu- 
matism by forming a soluble 
salt with uric acid. 



434 



POTASSIUM. 



thus become neutralized. 
These salts are of great im- 
portance for the nutrition of 
the muscles and the blood- 
corpuscles. 

3. Intestinal Tract. — Chlo- 
rate of potassium moderates 
excessive action of the saliva- 
ry glands, and assists the heal- 
ing of ulceration about the 
gums, mouth, and throat. 
The salts of potash generally 
neutralize free acid in the 
stomach and intestines, and 
the nitrate in full doses may 
cause death by gastroente- 
ritis. Most of the potash 
salts are slightly purgative, 
•but only the acid tartrate has 
any very decided action of 
this kind, causing as it does 
the abstraction of a large 
quantity of watery fluid, with- 
out, however, stimulating the 
peristaltic movement of the 
intestines. The sulphate is 
also aperient in its action. 

4. On Secreting Organs. — 
It will be remembered that, 
in speaking of acids, we re- 
ferred to a law which has 
been more especially devel- 
oped by Ringer, and which 
explains their power of check- 
ing acid secretions. Alkalies 
have precisely the opposite 
effect, arresting the activity 
of glands furnishing alkaline 
fluids, whilst they directly 
stimulate those whose secre- 
tion partakes of the opposite 
character. 



Scurvy is held by some to 
be dependent on a deficiency 
of potassium salts in the blood. 



3. Chlorate of potassium, 
in doses of from 5 to 20 grains, 
is an admirable remedy in 
mercurial salivation, in va- 
rious aphthous conditions, 
and in sore throat, whether 
produced by [diphtheritic 
croup"], scarlet fever, or ordi- 
nary tonsillar inflammation, 
and a wash or gargle may 
well be combined with its 
internal administration. 

In doses of from 120 to 
300 grains, cream of tartar 
is a good purgative, but is 
principally used in combina- 
tion with jalap, which, by 
stimulating the muscular 
movements of the. small in- 
testines, prevents the proba- 
ble reabsorption of the watery 
fluid. 

4. We can therefore read- 
ily explain, on physiological 
principles, why alkalies are 
so useful in hepatic conges- 
tion, why they may also stim- 
ulate the pancreatic secre- 
tion, and why their action is 
so beneficial in cases of dys- 
pepsia depending on deficient 
supplies of gastric juice. On 
these principles, also, we may 
readily understand the very 
striking power possessed by 
a weak solution of potash in 
arresting the alkaline secre- 



POTASSIUM. 



485 



Kidneys Most of the 

salts of potash, but more es- 
pecially the acetate, nitrate, 
citrate, and acid tartrate, are 
diuretic, and the acetate, bi- 
carbonate, and citrate, being 
converted into carbonate, 
speedily render the urine al- 
kaline. Elaborate experi- 
ments have been made on the 
more precise alterations ef- 
fected in the urine by the 
salts of potassium. Prof. 
Parkes tells us that liquor 
potassae increases the destruc- 
tive metamorphosis of the 
nitrogenous tissues, and their 
elimination as urea, as well 
as that of the sulphur in the 
form of sulphates. The ace- 
tate has been shown to di- 
minish the water, urea, and 
earthy salts ; whereas the 
citrate, according to Dr. Nun- 
neley, increases the water, 
but diminishes the urea and 
solids. 



Potash may be used under other conditions. Thus in 
asthma the inhalation of the fumes from burnt blotting- 
paper soaked in a strong solution of nitrate of potash is often 
effectual ; chlorate of potassium is a useful ingredient in a 
cough linctus ; the citrate is an agreeable febrifuge, and is 
valuable in many of the feverish and dyspeptic affections of 
children. 

Duckworth {Practitioner, May, 1878) highly praises nitre 
paper in bronchitis, and says that a little Friar's balsam 
painted over the paper is an improvement. This treatment 
in asthma often fails from the fumes not being used freely 
enough. 



tion so freely poured out by 
the skin in acute eczema. 

Potassium salts are there- 
fore good diuretics in heart 
disease, chronic kidney affec- 
tions, and various dropsical 
accumulations; and their ac- 
tion is much more marked 
under these conditions than 
when administered to healthy 
subjects, since we have seen 
that the acetate, which is 
perhaps the most active of 
the diuretic group, may even 
check the elimination of 
water from the kidneys dur- 
ing health. Dr. Roberts, of 
Manchester, has proposed to 
dissolve uric acid calculi by 
keeping the urine alkaline 
for months with citrate of 
potash. 



436 



POTASSIUM. 



Mode of Elimination. 

The potash salts, having a high diffusive power, pass 
readily into the blood, and are given out by the urine, in 
which the nitrate, chlorate, and sulphate reappear unchanged. 



I£. Liquoris potassse 
Tincturae calumbae 
Infusi calumbae 

Fiat mist, f §j ter die. 

Antacid mixture. 



f 5i j ; 


or 


8 


f3i.i; 


(< 


8 


fS^j; 


<( 


102 



Gm. 



M. 



]£. Potassii bicarbonatis gj ; or 4 

Potassii acetatis gr. xv; " 1 

Potassii nitratis gr. x ; " 

Aquae f f ij ; " 64 

Fiat haustus quartis horis sumend. 



Gm. 



65 



M. 



This constitutes the "full alkaline" treatment recom- 
mended by Dickinson for acute rheumatism, and may be 
prescribed in effervescence. 



[I£. Potassii chloratis 


5*J; 


or 


8 


Syrupi limonis 


fij; 


(i 


32 


Aquae 


f§iij; 


(< 


96 



Gm. 



M. 



Dose, according to the asre of the child: if under two 
years f3j, from two to ten I3> over ten F]§ss, given every 
three hours, or every half hour in urgent cases. Recom- 
mended as almost specific in diphtheritic croup by Dr. T. 
M. Drysdale.] 



S 



Potassii chloratis 

Aquae 

f :|ss ter die. 



3J; 



41 Gm. 

192 " 



M. 



In ulcerated mouth or gums, or mercurial salivation. 
R. 



Potassii bicarbonatis 
Aquae 



3 SS 
Oj; 



21 Gm. 
500 " 



A good lotion in acute eczema. 

R. Potassii acetatis 5i ss J 

Aceti scillse t'5iv ; 

Decocti sooparii TBr." 1 ad f "% j ; 

Fiat mist. Dose, f §j quartis horis. 

Diuretic mixture. 



16 

192 



Gm. 



M. 



M. 



POTASSIUM. 



437 



I£. Spiritus setheris nitrosi 
Potassii iritratis 
Decocti scoparii [Br.] 

Fiat mist. Dose, f Jj ter die. 

Diuretic. 

I£. Potassii bitartratis 
Succi scoparii [Br.] 
Aquae 

Dose, f 5j ter die. 

Diuretic. 



gr. xx 
f§iv; 



3 v j ; 



81 Gni. 



130 

128 



12 

24 
192 



Gm. 



M. 



M. 



I£. Potassii cliloratis gr. xl ; or 2 60 Gm. 

Glycerini fgss ; " 16 " 

Morphinse liydrochlorat. gr. jss ; " 10 " 

Sjrupi ad f giv ; " 128 " M. 

S» f 5J prout res poscit. 

Dr. Douglas Powell's linctus for the chronic throat irri- 
tation of consumptive patients. 



[Potassii Biehromas. 

Potassium bichromate, in powder or strong solution, is a 
good escharotic and antiseptic application to warts and ve- 
nereal excrescences. It is also useful in the treatment of nasal 
hypertrophies applied by means of a probe, to be immediately- 
followed by an alkaline wash. It has been used internally 
in secondary syphilis, as an alterative, given in pill-form 
with some bitter extract. Occasionally it produces saliva- 
tion. It acts as an emetic in doses of | gr. In large 
amounts it is an acrid mineral poison, and causes a burning 
heat in the mouth, throat, and stomach ; excessive and pain- 
ful vomiting of bloody mucus ; convulsions and palsy and 
death. 

Morbid Appearances Softening and abrasion of the 

mucous coat of the stomach and intestines. 

Tests In substance, by its orange-red color. In solu- 
tion, by affording a rich red precipitate with nitrate of silver, 
a bright yellow with acetate of lead, a dingy green color and 
whitish turbidity with sulphuretted hydrogen. 

Treatment The use of the potassium or sodium carbo- 
nates to neutralize the excess of chromic acid, followed by 
the administration of emetics. It would also be advisable 
to employ chalk or magnesia, in connection with milk, or 
the albumen of eggs.] 

37* 



438 



POTASSIUM. 



Potassii Bromidum. 

(Bromide of Potassium is not used externally.) 

Constitutional Actions. 



Physiological. 

1. On Nervous Function. 
— Long continuance in the 
use of potassium bromide 
tends to cause a sense of fa- 
tigue and general muscular 
prostration, with giddiness 
and staggering. 

Brain The functions of 

the brain are lessened, and 
sleep results, depending, like 
the normal physiological con- 
dition, on an anaemic condi- 
tion of the brain. 

Spinal Cord. — Experi- 
ment has shown that it les- 
sens and finally abolishes the 
reflex functions of the spinal 
cord, voluntary movement, 
which is at first unimpaired, 
finally becoming paralyzed. 
This is probably due to the 
potash, as potassium iodide 
and potassium chloride cause 
much the same symptoms, 
which are never observed af- 
ter the administration of the 
bromide of sodium. 

Potassium bromide also 
lessens the irritability of the 
sensory nerves. 

It has also been observed 
that the power of voluntary 
movement persists for some 
time after the abolition of re- 
flex function, proving that the 



Therapeutical. 

1. Potassium bromide has 
gained great repute within 
the last few years in the 
treatment of a large series of 
convulsive and spasmodic af- 
fections, and most especially 
in epilepsy, it being now tho- 
roughly established that if we 
get our case sufficiently early 
we may absolutely cure it, 
and even if it is too confirmed 
for this result we may keep 
it in check. The cases most 
under the influence of the 
drug are those known as the 
haut mal, where violent strug- 
gling is followed by comatose 
sleep; on the other hand, in 
the petit mal,' where the at- 
tack is indicated merely by 
passing unconsciousness, or 
when the seizures occur prin- 
cipally at night, the remedy 
will frequently disappoint us. 

When the remedy is act- 
ing well in epileptics, we will 
always readily detect a de- 
cided suppression of reflex 
sensibility at the back of 
tongue and fauces, free con- 
tact with a brush or spatula 
causing no feeling of nausea. 
Potassium bromide is be- 
lieved to act in epilepsy by 
relieving the spasmodic con- 



POTASSIUM. 



439 



influence of the drug is ex- 
erted probably either upon 
the afferent nerves, or upon 
those portions of the cord 
which transmit the impulse 
from these nerves to the cells 
presiding immediately over 
motion. 

Sympathetic System. — 
Potassium bromide is sup- 
posed to have a sedative in- 
fluence over the sympathetic 
system of nerves ; but on this 
point the evidence is very 
contradictory. 



2. Effects on Circulation. 
— No special action on the 
heart has been observed save 
some slight lowering of its 
action. The smaller arteries 
have been said to be con- 
tracted, the pulse becoming 
smaller, and we may thus 
explain the hypnotic action 
of the drug, the brain being 
rendered anaemic as in phy- 
siological sleep. 



traction of a vessel supplying 
a special vascular brain area 
which is thus deranged in 
function. 

It is also of great benefit 
in the various convulsive 
seizures of children, in laryn- 
gismus stridulus, night ter- 
rors, and also in those spas- 
modic symptoms which de- 
pend on meningitis or organic 
brain disease. 

It is of service in incon- 
tinence of urine, pertussis, 
cramp of lower limbs, chorea, 
in delirium tremens, and in 
many of those forms of men- 
tal depression, nervous head- 
ache, and vague sensations 
indicating nervous disturb- 
ance, which are so distres- 
sing to some women about 
the change of life. 

It is said to be a good 
remedy in sea-sickness from 
the sedative effect on the 
centre concerned in the reflex 
act of vomiting. 

2. Bromide of potassium 
is an excellent narcotic, and 
causes refreshing sleep, more 
especially in cases of in- 
somnia due to worry, mental 
anxiety, or overwork, a full 
dose being given at bedtime ; 
and in acute mania its use in 
combination with chloral is 
highly praised by Clouston. 

It is said to heighten the 
action of opium, and lessen 
the nausea, giddiness, and 
faintness occasionally follow- 
ing the use of that drug. 



440 POTASSIUM. 

3. Its influence on diges- 3. Its sedative influence 
tion is not marked ; for al- over reflex function has sug- 
though it sometimes seems to gested its use in some forms 
lessen the appetite, this is not of dyspepsia, and this seems 
a constant result. to have been successful. 

4. The effects on the uri- 4. It has been much praised 
nary secretion have not been by Begbie in diabetes. 
thoroughly made out. 

5. Bromide of potassium 5. It is useful in priapism 
has an undoubted influence and in those forms of menor- 
over the generative organs, rhagia which depend on ova- 
lowering their excitability, rian irritability, and it has 
and even in large doses sus- been used with success in the 
pending their action. acute stages of gonorrhoea, 

and in spasmodic stricture. 

Potassium bromide is eliminated from the system by the 
urine, breath, sweat, and milk, a case being recorded in 
which the child of a suckling mother taking the salt became 
covered with acne. 

Disadvantages and Contra-indications. 

We have already noted the peculiar nervous symptoms 
occasionally caused by the bromides — giddiness, general 
muscular fatigue, even amounting to actual staggering in 
some cases. But in addition to this an unpleasant eruption 
of acne often breaks out on the face, and may arise from a 
very small dose. If the remedy is persisted in, in spite of 
this, the whole body may eventually be covered with large 
and unsightly blotches. 

Bromide acne may, in some measure, be prevented by 
adding a little liq. acidi arseniosi to each dose, and may be 
removed by the following lotion : — 



I£. Sulpliuris prsecip. §iij ; 


or 121 Gm. 


Spiritus cainphorae f 3J ; 


(< 4 <( 


Aq. calcis ad f §iij ; 


" 96| " 


Ft. lotio. 




Apply morning and evening. 





Sodii bromidum acts much in the same way as potassium 
bromidum [but is considered to be less depressing to the 
heart. The ammonium bromide is better where the circu- 
lation is defective]. 



POTASSIUM. 



441 



Dose and Mode of Administration. 

The dose for epilepsy ranges from 10 to 60 grains, it being 
necessary to increase the quantity gradually, and continue 
its use for long periods, even years, occasionally leaving it 
off for a week or so, after which it seems to regain some of 
its lost effect . 

Dose as a hypnotic, gr. xx ad xxx. In other cases about 
gr. xx as an average. Children appear to be very suscep- 
tible to its use, acne being readily produced in them by 
moderate doses. As its taste is rather nauseous, we must 
disguise it thus : — 



R. Potassii bromidi gr. xxx 

Syrupi aurantii f 5i ; 

Aquae aurantii florum q. s. ad f§ij ; 

Fiat haustus hora somni suinendus. 



[R. Pot. bromidi 

Chloral hydratis 

Aquae camphorse 
Dose, 3J thrice a day. 

Or, give it simply in water.] 

R. Potassii bromidi 
Morphinae acetatis 
Glycerini 
Chloroformi 



9; 

§ss; 
Sviij 



3"j ; 


or 4 


gr. x ; 


a 


SiJ ; 


" 64 


5iij; 


« 12 



2 

4 

64 

32 

16 

256 



(35 



Gm. 



M. 



Gm. 



M. 



Recommended by Schrbtter as an efficient means for les- 
sening the sensibility of the fauces and larynx previous to 
operation. Frequent applications should be made by brush. 

[A brominized solution of bromide of potassium has been 
recommended for laryngeal diphtheria or pseudo-membranous 
croup — 

R. Potassii bromidi %} ; or 4 Gm. 

Bromini Vtiv ; " 30 " 

Syrupi simplicis f5viiss ; " 30 " 

Decocti althsese giij ; 5vj ; " 120 " M. 

Dose, f 3j every hour duririg urgeut symptoms. 

For children under one year the quantity of bromine in 
the mixture should be reduced to 0.10 Gm., and for those 
from one to four years old to .20 Gm. 1 ] 



1 Redenbacher-iErtzlicries Intelligensblatt, January 7, 1879. 
The Practitioner, vol. xxii. p. 208. 



442 PRINOS. 

Potassii Iodidum (Iodide of Potassium). 

(For Constitutional Effects see Iodine, page 342.) 

Potassium iodide as an anti-syphilitic may be given in 
doses of from 3 to 30 grains, or even 60, according to the 
judgment of prescribers, it being necessary in obstinate cases 
to push the drug very freely. 

[The iodide of potassium should be prescribed alone, or 
only in combination with other preparations of iodine, or 
with corrosive sublimate. 

This salt may be given simply dissolved in water, or its 
taste may be well disguised by administering it in combina- 
tion with compound syrup of sarsaparilla, or compound infu- 
sion of gentian. 

Dr. Taylor, at the meeting of the American Dermatolo- 
gical Association, said that patients would tolerate an ounce 
and a half daily and grow fat on it, the only physiological 
result being increased .urination. He mentioned a case of 
nodes, where fourteen drachms daily were administered ; 
nothing less would give the patient relief at night. He 
thought that in similar cases the addition of bromide of 
potassium, one drachm to seven of the iodide, would be of 
advantage. 

He also remarked that he had observed pains in the joints 
occasionally, even when small doses of iodide were being 
administered, which were considered as being due to the 
remedies employed. He offered a practical suggestion in 
reference to the prevention of these pains (which are diurnal 
and not nocturnal), which was that tincture of colchicum 
and tincture of hyoscyamus, combined with small doses of 
the iodide of potassium, would obviate them. Occasionally 
it is necessary to use camphorated oil, or some warming 
application externally. The joint trouble is sometimes poly- 
articular, sometimes mon-articular.] 



[PRINOS— PRINOS (BLACK ALDER). 

The bark of Prinos Verticellatus, Linne* (Hex Verticellata, Gray, 
N. 0. Aquifoliacece) . 

An indigenous drug of decided astringent properties, which 
make it useful in the form of a decoction, or fluid extract, 
in gastric disorders and in diarrhcea.~\ 



PULSATILLA. 443 

PRUNUM—PRUNE. 

[The fruit of Prunus domestica, Linne (N. 0. Rosacea, Amygdalece). 

Enters into Confectio Sennse.] 
Prunes are slightly purgative. 



[PRUNUS VIRGINIANA—WILD CHERRY. 

The bark of Prunus Serotina, Ehrhart (Cerasus Serotina, Loiseleur 
(iV. 0. Hosacece, Amygdaleaz) , collected in Autumn. 

Officinal Preparations, U. S. 

Extractum Pruni Virginians Fluidum. Dose, 
5ss to f 3j (2. to 4. Gm.). 

Infusum Pruni Virginians (4 per cent.). Dose, 
fgj-iij (30. to 96 Gm.). 

Syrupus Pruni Virginians. Dose, 3j to f^ss (4. 
to 16. Gm.). 

Wild cherry bark is tonic and sedative, the freshly pre- 
pared preparations containing a small amount of hydrocyanic 
acid. The syrup, from its pleasant flavor, is much used as 
an ingredient in cough syrups for phthisis, or chronic bron- 
chitis.'] 



[PULSATILLA— PULSATILLA. 

The herb of Anemone Pulsatilla and Anemone pratensis, Linne, and of 
Anemone patens, Linne, var. Nuttalliana Gray {N. 0. Ranunculacece) , 
collected soon after flowering. It should be carefully preserved, and 
not kept longer than one year. 

Pulsatilla has a reputation among irregular practitioners 
as an emmenagogue and alterative ; its asserted virtues have 
not stood the test of experience. In large doses it may pro- 
duce nausea and vomiting.] 



[Pulveres. 

The officinal Powders are — 

Pulvis Antimonialis. — James's powder. 
" Aromaticus. — Spice powder. 
" Cretae Compositus. 



444 PYRETHRUM — QUASSIA. 

Pulvis Effervescens Compositus. — Seidlitz powders. 
" Glycyrrhizae Compositus. 
" Ipecacuanhse et Opii.— Dover's powder. 
" Jalapse Compositus. — Jalap and cream of tartar. 
" Morphinae Compositus. — Camphor, Glycyrrhiza, Calcium 

Carb. ; Morphinae Sulphas (1 part to 60). 
" Rhei Compositus. — Rhubarb, magnesia, and ginger.] 



[PYRETHRUM- PYRETHRUM (PELLITORY). 

The root of Anacyclus Pyrethrum, DeCandolle (N. 0. Composites). 

The ground flower-heads of pyrethrum roseum are very- 
destructive to insect life, and are sold as Persian Insect Pow- 
der. Pellitory root contains a volatile oil and acrid resin ; it 
is a sialagogue, and is said to be useful as a local remedy in 
neuralgia, paralysis of the tongue, etc. Dose, 15 to 60 
grains (1. to 4. Gm.), to be chewed slowly.] 



[PYROXYLINUM— PYROXYLIN (SOLUBLE GUN 
COTTON). 

Collodium. (Gun cotton 4, dissolved in ether 70, and 
alcohol 26 parts. For external use as a protective.) 

Gun-cotton is white, dry, and entirely soluble in a mixture 
of alcohol and ether. It is inflammable, and violently explo- 
sive. It is used in preparing Collodion (see page 269).] 



QUASSIA—QUASSIA. 

\Thevoood of Picrcena excelsa, Lindley (Quassia excelsa, Swartz) 
(N. 0. Simarubacece). 

Officinal Preparations, U. S. 

Extractum Quassiae. Dose, gr. j-iij (.06 to .20 
Gm.). 

Extractum Quassiae Fluidum. Dose, n^v-xx 
(.30 to 1.30 Gm.). 

Tinetura Quassiae (10 per cent.). Dose, gtt. xx-f3j 
(1.30 to 4. Gm.).] 



WHITE OAK — RESIN. 445 

Physiological Actions. Therapeutical Actions. 

The action of quassia is Quassia is much used as a 
directed to the gastro-intes- tonic in dyspepsia, want of 
tinal mucous membrane, and appetite, and general debility, 
it is probable that its in- Having no aromatic flavor, it 
tensely bitter taste may stim- is sometimes badly^ borne by 
ulate the secretion of gastric weak stomachs, but, being 
juice, as it certainly increases very cheap, it is largely pre- 
the appetite. scribed in dispensary prac- 

tice, more especially in com- 
bination with iron. 

Quassia is destructive to It is therefore of service, 
many of the lower forms of given as an enema, for the 
animal life. destruction of thread worms. 



QUERCUS ALBA— WHITE OAK. 

[The bark of Quercus alba, LinnS (iV. 0. Cupuliferaz) .] 

Oak bark contains tannic and gallic acids, and the decoc- 
tion is therefore of some value as an astringent in relaxed 
throat, leucorrhoea, etc. 



[QUILLAIA— QUILLAIA (SOAP BARK). 

The bark of Quillaia Saponaria, Molina (N. 0. Rosacea?, Rosece). 

Quillaia contains saponin and has been recommended as a 
substitute for senega as an expectorant. It is also diuretic 
and alterative. Its solutions froth easily when shaken 
(hence its name of soap-tree bark), and its tincture is a good 
addition to dentifrices, or mouth-washes. It is irritating to 
the mucous passages, and has been used as a snuff in coryza~\ 



[RESINA— RESIN (COLOPHONY). 

The residue left after distilling off the volatile oil from turpentine, 

Ceratum Resinae (Resin 35, yellow wax 15, lard 50 
parts). 

Linimentum Terebinthinae (Resin Cerate 65, 
Oil of Turpentine 35 parts). 
38 



446 RHUBARB. 

Emplastrum Resinae (Adhesive Plaster). 

Enters into Ceratum Cantharidis, Ceratum Extracti Can- 
tharidis, Ceratum Sabinae, and Emplastrum Hydrargyri. 

Has no great therapeutic interest, except in its pharma- 
ceutical relations. It has been recommended in five to ten 
grain doses for chronic diarrhoea, but is seldom used inter- 
nally.] 



[Resinas. 

The officinal Resins are — 

Resin a Copaibse Resina Podophylli 

" Jalapse " Scammonii.] 



RHEUM—RHUBARB. 

[ The root of Rheum officinale, Baillon, and of other undetermined species 
of Rheum (N. 0. Polygonaceoz). 

Officinal Preparations, U. S. 

Extractum Rhei. Dose, gr. ij-x (.12 to .65 Gm.). 

Extraetum Rhei Fluidum. Dose, gtt. x-xxv (.65 
to 1.60 Gm.). 

Infusum Rhei (3iv to Oj). Dose, f^ij-iv (64. to 
128. Gm.). 

Pilulffi Rhei (each gr. iij). Dose, 1 to 3 pills. 

Pilulffi Rhei Composite (Rhei gr. ij, aloes gr. iss, 
myrrh gr. j). Dose, 2 to 4 pills. 

Pulvis Rhei Compositus (Rhubarb 25, magnesia 
65, and ginger 10). Dose, 3 ss ~j (2- to 4. Gm.). 

Syrupus Rhei (9 per cent.). Dose, f'3ss— ij (4. to 8. 
Gm.). 

Syrupus Rhei Aromaticus (10 per cent, of the 
Tincture of Rhubarb). Dose, for infant, f'3 (4. Gm.). 

Mistura Rhei et Sodas (Sod. bicarb., fl. ext. rhei 
sp. peppermint aa 30, water 10). Dose, 5 ss -ij (2. to 8. 
Gm.). 

Tinctura Rhei (12 per cent.). Dose, f^ss-j (16. to 
32. Gm.). 

Tinctura Rhei Aromatiea (20 per cent.). Dose, 
fgss-j (16. to 32. Gm.). 



RHUBARB, 



447 



Vinum Rhei (10 per cent.). Dose, f 5j-iv (4. to 16. 
Gm.). 

Tinetura Rhei Dulcis (8 per cent.). Dose, 5y-«j 
(8 to 12 Gm.).] 

Constitutional Action. 
Physiological. Therapeutical. 



Like castor oil, rhubarb 
combines some astringent 
properties with its undoubted 
cathartic effects ; and whilst 
the first-mentioned action is 
no doubt due to the tannin 
which it contains, investiga- 
tors have not yet determined 
on what special ingredient 
its purgative powers depend. 

When taken in consider- 
able doses, it not only stimu- 
lates the peristaltic move- 
ments of the small intestine, 
and more especially the duo- 
denum, but it moistens and 
softens the feces, and in- 
creases decidedly the secre- 
tion of bile. According to 
Rutherford, it is a certain 
though not a powerful hepa- 
tic stimulant. The bile 
secreted under its influence 
has the normal composition. 

The chrysophanic acid, or yellow coloring matter of 
rhubarb, is readily absorbed, and rapidly given out by the 
intestines, milk, sweat, and urine, to which latter secretion 
it imparts a yellow tinge, turning red on the addition of an 
alkali. [For use of chrysophanic acid in skin diseases, see 
Chrysarobinum, page 250.] 

Dose, Mode of Administration, etc. 

The smell and flavor of rhubarb are excessively nauseous, 
and, although we cannot effectually disguise either, we may 



The astringent action of 
rhubarb renders it most use- 
ful in those forms of diar- 
rhoea depending on the pre- 
sence of indigestible matters 
in the alimentary canal, and 
where removal of the excit- 
ing cause, followed by rest 
of the irritated intestine, is 
sufficient to effect a cure. 

It is a good tonic in some 
cases of dyspepsia, and forms 
a good purgative for children, 
more especially when com- 
bined with magnesia, as in 
the well-known Gregory's 
Powder [Pulv. Rhei Comp.]. 

Prof. Rutherford's experi- 
ments on its cholagogue ac- 
tion would indicate its em- 
ployment in jaundice and 
deficient secretion of bile. 



448 



RHUS GLABRA — RHUS TOXICODENDRON. 



at least render the drug moderately palatable by the follow- 
in 2 formulae : — 



R. Infusi rhei f§ij ; 

Potassii bi carbon atis 5j 5 

Tincturse cinnamomi f^ij ; 

Syrupi simplicis f3vj ; 

Dose, f5j secunda quaque hora. 

In the diarrhoea of children. 

I£. Pulveris rbei gr. xxx 

Sodii carbonatis gr. xv ; 

Spiritus myristicse n\,xxx ; 

Syrupi zingiberis f5j ; 

Aquae menthae piperitae q.s.ad l§iss ; 
Misce, fiat haustus nocte sumendus. 

Antacid and purgative. 



Gm. 



Gm. 



M. 



[RHUS GLABRA—RHUS GLABRA (SUMACH). 

The fruit of Rhus Glabra (N. 0. Terebinthacece, Anacardieoz) . 

Extraetum Rhois Glabrae Fluidum. Dose, f3j- 
ii (4-8 Gm.). 

Sumach contains tannic acid, and in the form of fluid 
extract of the fruit, it is a good addition to mouth-washes or 
as a spray in pharyngitis. It has also been administered 
internally in diarrhoea., and in strangury. In some skin 
diseases, and in ulcers it may be applied diluted as a wash.] 



[RHUS TOXICODENDRON— RHUS TOXI- 
CODENDRON (POISON IVY). 

The fresh leaves of Rhus Toxicodendron, Michaux (Rhus Toxicodendron 
and Rhus Radicans) (N. 0. Terebinthaceoz, Anacardieoz) . 

The fresh leaves contain an acrid principle, toxicodendric 
acid, which causes vesicular inflammation and swelling of 
the skin ; for which alkaline solutions of carbonate of potas- 
sium or bicarbonate of sodium may be used to neutralize 
the poison, followed by astringents. A tincture of the leaves 
was formerly used in paralysis, and in chronic rheumatism. 
The dried leaves are worthless.] 



PALE ROSE — ROSEMARY. 449 

ROSA CENTIFOLIA— PALE ROSE. 

The petals of Rosa centifolia, Linne (A T .0. Rosacea, Rosea?). 

ROSA GALLICA— RED ROSE. 

The petals of Rosa Gallica, Linne, collected before expanding 
(iV. 0. Rosacea?, Rosea?.). 

OLEUM ROS^E. 

The volatile oil distilled from the fresh flowers of Rosa Damascena, 
Miller (N. 0. Rosaceoz, Rosece). 

Officinal Preparations, U. S. 

Aqua Rosae (Rosa centifolia). As a vehicle. 

Unguentum Aquae Rosae (Cold Cream). External 
use. 

Confectio Rosae. As an excipient for pills. 

Extract um Rosae Fluidum (containing glycerine 
and dilute alcohol). As a vehicle. 

Mel Rosae. (Honey of Roses.) As a vehicle. 

Syrupus Rosae. As a vehicle. 

Red Rose also enters into Pilulse Aloes et Mastiches, and 
Pale Roses into Syrupus Sarsaparillas Compositus.] 

The various preparations of roses have little therapeutical 
significance. The cabbage-rose is used in the form of rose- 
water as an elegant vehicle ; the red-rose petals as confection 
constitute a convenient basis for a pill mass, whilst, com- 
bined with sulphuric acid in the acid infusion, they make an 
excellent gargle, either alone or with alum, whilst they may 
occasionally be of service in concealing the nauseous flavor 
of sulphate of magnesia. 

Hips [dog-rose, rosce canince fructus, Br.] are also 
slightly astringent. 



ROSMARINUS— ROSEMARY. 

[ The leaves of Rosmarinus officinalis, Linne (N. 0. Labiatce). 
Oleum Rosmarini. Used in Linimentum Saponis. 

Rosemary, lavender, and peppermint are agreeable car- 
minatives, much used in combination with other stimulant 
drugs. (The oil of rosemary is one of the constituents of 

38* 



450 RUBUS — RUMEX. 

the Compound Tincture of Lavender, Linimentum Saponis, 
Spiritus Odoratus and Vinum Aromaticum.)] 



[RUBUS— RUBUS (BLACKBERRY). 

The bark of the root of Rubas villosus, Aiton, Rubus Canadensis, Linne", 
and Rubus trivialis, Michaux (N. 0. Rosacea?, Dryadeoz). 

Officinal Preparations, U. S. 

Extractum Rubi Fluidum. Dose, f5ss (2. Gm.). 
Syrupus Rubi (20 per cent, fluid extract). Dose, 
f3j-ij (4. to 8. Gm.). 

Much prized as a tonic and astringent, and particularly 
adapted to the diarrhoea of relaxation. A decoction is also 
made in domestic practice (^j to Oiss boiled down to a pint), 
of which f 3j-ij (32. to 64. Gm.) may be given three or four 
times daily.] 



RUBUS IDiEUS— RASPBERRY. 

The fruit of Rubus idaius, Linne* (N. 0. Rosacea?, Dryadeai) . 

Syrupus Rubus Idaei. As a vehicle. 

Raspberry is used for flavoring. In combination with 
vinegar and sugar it makes an agreeable acid hot-weather 
drink. It possibly may be useful in scorbutus.] 



RUMEX— RUMEX (YELLOW DOCK). 

The root of Rumex Crispus, Linne, and of other species of Rumex 
(N. 0. Polyyonaceoi). 

Extractum Rumicis Fluidum. Dose, 5 ss -j ( 2 t0 
4 Gm.). 

Rumex or yellow dock contains chrysophanic acid, tan- 
nic acid, etc., and possesses alterative tonic properties. It 
has been used in the fluid extract (3 ss -j) in dyspepsia and 
liver disorders. Also in various syphilitic and scrofulous 
affections, skin diseases, glandular swellings, etc.] 



OIL OF RUE — SAVINE. 451 



[RUT^E OLEUM— OIL OF RUE. 

A volatile oil distilled from Rata Graveolens, Linne* (N. 0. Rutaceoz, 
Rutece). 

The oil of rue is stimulant, and, in large doses, is an acro- 
narcotic poison. Moderate doses have some emmenagogue 
effects, and, in cases of poisoning, miscarriage generally 
occurs.] 



SABINA— SAVINE. 

[ The tops of Juniperus Sabina, Linne (iV. 0. Coniferoz). 
Dose, in substance, gr. v— xv (.30 to 1 Gm.). 

Officinal Preparations, U. S. 

Ceratum Sabinae (Fluid extract, 25 parts; Resin 
Cerate, 90 parts). External use. 

Extraetum Sabina? Fluidum. Dose, gtt. v-xv 
(.30 to 1. Gm.)- 

Oleum Sabina?. Dose, gtt. ij-v (.12 to .30 Gm.).] 

Local Effects. 

Savine used to be applied in the form of ointment to blis- 
tered surfaces, with the view of encouraging suppuration, but 
this barbarous process is now happily abandoned. [It is 
stimulant and rubefacient, and is sometimes applied to warts, 
ulcers, and diseases of* the scalp.] 

Internal Uses. 

Physiological. Therapeutical. 

Savine isagastro-intestinal Savine is sometimes used 
irritant, causing in large with criminal intent to pro- 
doses vomiting and purging; duce abortion, and death has 
and it has also a powerful occasionally resulted from its 
stimulating influence on the irritant action. It is rarely 
uterus. used in medicine, although 

some authorities express faith 
in its emmenagogue powers. 



452 SUGAR — SALICIN. 



SACCHARUM— SUGAR. 

[ The refined sugar of Saccharum officinarum, Linne" 
(iV. 0. Graminacece) . 

(CAO n ; 342.) 

Officinal Preparations. 

Syrupus. (Sugar 65 parts, water q. s. ad 100 parts 
by weight.) 

Sugar enters into Pilula Ferri Carbonatis, Pilulse Ferri 
Iodidi, and the various syrups.] 

Sugar is principally used in the form of syrup as a flavor- 
ing adjunct. [Molasses is laxative ; and molasses candy 
sometimes forms a good substitute for more active remedies 
in treating constipation in children.] 



SACCHARUM LACTIS— SUGAR OF MILK. 

[A peculiar crystalline sugar obtained from the whey of cow'' s milk by 
evaporation and purified by recrystallization. 

Milk, and sugar of milk, have no special therapeutical 
properties apart from their nourishing qualities. [Sugar of 
milk on account of its dryness and hardness is useful in phar- 
macy as the vehicle for other substances in the form of tritu- 
rates, abstracts, etc.] 



[SALIX— SALIX (WILLOW). 

The bark of Salix alba, Linne', and of other species of Salix 
(N. 0. Salicaceoz).] 

SALICINUM—SALICIN. 

[J. neutral principle prepared from the bark of Salix Helix, Linne', and 
of other species of Salix (N. 0. Salicacece). 

Salicin acts as a bitter tonic, and has some antiseptic and 
antiperiodic qualities, which have caused it to be used, with 
only partial success, in the treatment of malarial affections. 
Recently, however, it has been most extensively employed 
as a remedy for acute rheumatism, on the recommendation 
of Dr. Maclagan, who holds it to be safer than salicylic acid, 



SALVIA — SANGUINARIA. 453 

as not tending to depress the heart, the dose being from 10 
to 50 grains every two, three, or four hours ; and if we wish 
to get the full antipyretic effect of the remedy we must pre- 
scribe it boldly in 2 or 3 doses of 30 to 50 grains repeated 
at hourly intervals. He also praises it highly in periodic 
neuralgia and coryza. 



SALVIA—SALVIA (SAGE). 
The leaves of Salvia officinalis, Linns' (N. 0. Labiates'). 

Officinal Preparation, U. S. 

Vinum Aromaticum. (See page 95.) 

Sage is tonic, astringent, and aromatic. It has been used 
as a carminative in debility of the stomach with flatulence, 
and the infusion is a useful gargle, to which honey, alum, or 
vinegar may be added, but it strikes a black color with iron 
(it contains tannic acid). A weak infusion is sometimes 
used as a drink in fevers to allay nausea.] 



SAMBUCUS— SAMBUCUS (ELDER). 

[The flowers of Sambucus Canadensis, Linn6 (N. 0. Caprifoliacece) .~\ 

Dose, gr. xxx-3j (2 to 4 Gm.). 

Only used in the form of aquae sambuci [Br.], which is a 
cooling and pleasant lotion. [The root of Sambucus nigri 
(common black elder-berry) acts as a hydragogue cathartic. 
The expressed juice of the root may be given in doses of 
3j-ij until salivation, vomiting, and purging occur; or a 
decoction may also be made. A hot infusion of sambucus is 
diaphoretic, diuretic, and may be emetic] 



SANGUINARIA—SANGUINARIA (BLOODROOT). 

[ The rhizome of Sanguinaria Canadensis, Linns (N. 0. Papaveraceos) , 
collected in autumn. 

Officinal Preparations, U. S. 

Aeetum Sanguinaria^ (10 per cent.). Dose, nr,xv- 
xxx (1. to 2. Gm.). 



454 RED SAUNDERS — SANTONICA. 

Tinctura Sanguinariae (15 per cent.). Dose, gtt. 
xx-xl (1.30 to 2.G0 Gm.J. 

Extraetum Sanguinariae Fluidum. Dose, nv,ij-v 
(.13 to .30 Gm.).] 

This is a substance of energetic physiological properties, 
causing clonic convulsions of spinal origin, diminishing 
reflex action, weakening the force of the heart, and lessen- 
ing arterial tension, lowering the temperature, dilating the 
pupil, and finally causing death by respiratory paralysis. It 
also possesses violent emetic properties, and stimulates he- 
patic secretion. It has been used more especially in America, 
and has been found useful in atonic dyspepsia and duodenal 
jaundice, in chronic catarrh, and some stages of bronchitis, 
and may be given in doses of 5 to 10 minims of the tinc- 
ture three times a day. [The powdered root has been used 
as a stimulant in indolent ulcers, which has led some to con- 
sider it a specific for cancer.'] 



[SANTALUM RUBRUM—RED SAUNDERS. 

The wood of Pterocarpus santalinus, Linne* (Leguminosce, Papilionacece). 

Used only in pharmacy as a coloring agent, and enters 
into Tinctura Lavandulae Compositus.] 



SANTONICA— SANTONICA. 

[ The unexpanded flower heads of Artemisia Maritima, Var. Stech- 
manniana, Besser (N. 0. Compositce). 

Santoninum. A neutral principle prepared from San< 
tonica. Dose, gr. ss-iij (.03 to .20 Gm.). 

Officinal Preparations, U. S. 

Sodii Santoninas. Dose, gr. ij-x (.13 to .65 Gm.). 
Troehisci Santonini (each, gr. j) Dose 1 to 3.] 

Local Action. 
Santonin has no local action. 



SANTONICA. 



455 



Internal Actions. 



Physiological. 

I. Brain and Nervous 

System It is no doubt due 

to some influence on the brain 
that the peculiar derange- 
ment of vision, which is some- 
times found accompanying 
the use of santonin, de- 
pends ; as no staining of the 
ocular media has been ob- 
served, and slight hyperemia 
of the retina is the only ap- 
parent local effect. Some 
observers note the first stage 
to be an exaggerated appre- 
ciation of the violet rays of 
the spectrum, but the most 
evident alteration in sight 
consists in very distinct yel- 
low vision, all white objects 
being seen in a more or less 
pronounced saffron tinge, 
which begins about half an 
hour after the drug is swal- 
lowed. Associated with this 
we find a diminished or even 
abolished appreciation of the 
violet rays of the spectrum. 
A good deal of lassitude and 
mental depression usually 
follows the use of this medi- 
cine, and it must be cau- 
tiously pushed, as large doses 
have occasionally proved 
fatal from tetanic spasms and 
convulsions and coma. 

II. Respiration and Cir- 
culation — No special influ- 
ence on these functions has 
been noted. [In poisoning 
there is accelerated and 



Therapeutical. 



I. Santonin has been re- 
commended as a remedy for 
some affections of the optic 
nerve, but no trustworthy 
evidence has yet been adduced 
of its efficacy. 



Santonin has not been used 
in any form of nerve disease, 
but it seems at least possible 
that it might prove of service 
in some forms of so-called 
color-blindness. 



456 



SANTONICA. 



feeble pulse and rapid respi- 
ration.] 

III. Secreting Organs. — 
Slight digestive disturbance 
is usually experienced, indi- 
cated by nausea, headache, 
and general malaise. 



Urinary Organs Re- 
markable effects are here 
noted, consisting of a bright 
yellow coloration of the 
urine, beginning five min- 
utes after a few grains have 
been swallowed, persisting 
for two or three days, and 
communicating a stain to 
linen, as in the case of jaun- 
dice. Should the urine hap- 
pen to be alkaline, the color 
assumes a blood-red tinge, 
and the same change fol- 
lows the addition of ammo- 
nia to the acid secretion. 
At the same time the flow of 
urine is increased, the pa- 
tient experiences an irresisti- 
ble desire to micturate, and 
in the case of children this 
may even give rise to com- 
plete temporary incontinence. 



III. The real use of san- 
tonin in practice consists in 
its effect on the round worm, 
or ascaris himbricoides, 
which it speedily destroys. 
It appears to have no influ- 
ence over the tape-worm, 
and it is an open question 
with regard to its services in 
cases of ascaris vermicularis. 



Santonin has been recom- 
mended as a remedy for in- 
continence of urine, but 
although it is said to succeed 
occasionally in cases of this 
troublesome affection after 
other remedies have failed, 
careful observation has con- 
vinced me that this assertion 
is entirely without founda- 
tion. 



Mode of Elimination. 

Santonin is supposed to combine with the soda in the 
blood, and to be given out, in part at least, by the urine 
under the form of xanthopsin. 



SOAP — GREEN SOAP. 45 I 

Cautions. Mode of Administration. 

[Binz has related a case of santonin-poisoning in which, 
apparently, a small dose produced serious symptoms. Two 
lozenges, containing less than a grain, were followed, ten 
hours afterwards, by a convulsive attack which recurred sev- 
eral times during the next few days. The child never had 
convulsions before. It would seem as if the troches must 
have contained more of the drug than was suspected. 1 ] 

As already observed, serious symptoms have been observed 
to follow the use of santonin, and we shall do well to warn 
our patients of the urinary irritability which is invariably 
experienced in greater or less degree. Dr. Sieveking has 
also drawn attention to the occurrence of urticaria following 
the administration of santonin, and Drs. Dyce and Ogson 
have given a suggestive hint by pointing out that its long- 
continued use causes the development of cataract in young 
animals. 

[If long retained in the system santonin becomes converted 
into xanthopsia, which then appears in the urine. Poisonous 
symptoms are produced by this new substance, but they may 
be prevented by combining the santonin with an antacid 
and purgative, and in practice it is found that they are 
never produced when the santonin is combined with calomel 
and soda.] 

Its taste is not unpleasant, but as it is insoluble in water 
it may be mixed with jam or treacle, or simply sprinkled on 
bread and butter [or we may use the officinal lozenge]. 



SAPO— SOAP. 

[Soap prepared from soda and olive oil. ] 

[SAPO VIRIDIS— GREEN SOAP. 

Soap prepared from potassa and fixed oils. 

Officinal Preparations, U. S. 

Emplastrum Saponis. 
Linimentum Saponis. 

Tinctura Saponis Viridis. (Green soap 65, oil 
of lavender 2, alcohol q. s. ad 100.) 

1 [Phil. Med. Times, Aug. 1877, p. 551.] 
39 



458 SARSAPARILLA. 

Enters into Extractum Colocynthidis Compositum, Pilulse 
Aloes, Pil. Aloes et Asafcetidae, Pil. Asafoetidae, Pil. Opii, 
Pil. Rhei, Pil. Rhei Composite, and Pil. Scillae Com- 
posite.] 

Soap is not applied to any therapeutical purpose, except 
the hard variety, which enters into the construction of some 
pill masses, and both the hard and soft aid in the construc- 
tion of liniments and plasters. 

[Soft, or potassa, soap, green soap, sapo viridis, has been 
recommended by Hebra in alcoholic solution, under the name 
of spiriius saponis kalinis (2 pts. soap, 1 pt. alcohol), in the 
treatment of chronic eczema.'] 



SARSAPARILLA— SARSAPARILLA. 

[ The root of Smilax officinalis, Kunth, Smilax medica, Schlechtendal 
et Chamisso, and of other undetermined species of Smilax (iV. 0. 
Smilacece. ) 

Officinal Preparations, U. S. 

Decoctum Sarsaparillae Compositum (two parts 
of sarsaparilla, two each of sassafras, guaiac and licorice, 
one of mezereum and water q. s. to make 100 parts). Dose, 
fgij-iv (60. to 128. Gm.). 

Extractum Sarsaparillae Fluidum. Dose, f 3ss-j 
(2. to 4. Gm.). 

Extractum Sarsaparillae Compositum Flui- 
dum. Dose, f*3ss-j (2. to 4. Gm.). 

Syrupus Sarsaparillae Compositus (£iv to Oj). 
Dose, f 3j-iv (4. to 6. Gm.).] 

Internal Actions. 

Physiological. Therapeutical. 

Sarsaparilla has been cred- Nor is it easier to give 

ited with diaphoretic, diu- any decided opinion regard- 

retic, and other powers ; but ing its therapeutical merits; 

none of these have stood the for whilst some surgeons, 

test of rigid investigation, like the late Mr. Syme, hold 

and it is difficult to find any it to be quite useless, others 

convenient heading under believe it to be of service 

which to class this popular in constitutional syphilis, 

drug, unless we shelve the chronic skin disease, etc. 



SASSAFRAS — SCAMMONY. 459 

difficulty by calling it an One point of difficulty in ar- 
" alterative." riving at any decided con- 

Experiment has shown that elusion is, that it is usually 
this expensiveand fashionable prescribed along with three 
drug is quite devoid of all other drugs in the compound 
physiological properties. decoction; but the late Mr. 

Gascoyne used to say that he 
had found great benefit in 
the treatment of the tertiary 
forms of syphilis by giving 
full doses of the freshly made 
infusion. 



SASSAFRAS— SASSAFRAS. 

\_The bark of the root of Sassafras officinalis, Nees (N. 0. Lauracece). 
SASSAFRAS MEDULLA—SASSAFRAS PITH. 

the pith of Sassafras officinalis (N. 0. Lauracece). 

Oleum Sassafras. Dose, gtt. ij_ x (.12 to .62 Gm.). 

Mucilago Sassafras Medullae (5\j to Oj). Exter- 
nal use. 

Enters into Extractum Sarsaparillse Compositum Flui- 
dum, and Decoctum Sarsaparillas Compositum and Syrupus 
Sarsaparillse Compositus.] 

This plant seems only to have acquired any therapeutic 
importance by reason of its combination with other drugs 
in the Decoctum Sarsaparillae Comp. [The mucilage may be 
used as a soothing application in conjunctivitis. The oil is a 
pleasant flavoring substance, and is carminative.] 



SCAMMONIUM— SCAMMONY. 

[A resinous exudation from the root of Convolvulus Scammonia 
(N. 0. Convolvulacece). 

Dose, in substance, gr. v-xv (.30 to 1. Gm.). 

Officinal Preparations, U. S. 

ResinaSeammonii. Dose.crr. iv-viij (.25 to .50 Gm.). 
Extractum Colocynthidis Compositum. Dose, 
gr. v-xxx (.30 to 2. Gm.). (See Coloc?nth.)] 



460 SQUILL. 

Internal Effects. 

Physiological. Therapeutical. 

Scammony causes a good Seammony is a purgative 
deal of irritation of the ali- used in cerebral and dropsical 
mentary canal, and produces affections; and being com- 
copions watery stools, often paratively tasteless, it is well 
attended with griping. For adapted foi children, forming 
its proper action, previous a convenient purgative for 
solution in the bile, and com- the removal of ascarides. [It 
bination with its soda, are may be given in milk.] 
requisite. The experiments 
of Rutherford have proved 
that scammony is a powerful 
intestinal, but a feeble hepatic 
stimulant. 



SCILLA— SQUILL. 

[ The sliced bulb of Urginea Scillce, Steinheil (N. 0. Liliaceoe). 

Dose, in substance, gr. ij (.12 Gm.). 

Active principles, scillitoxin and skulein (or scillitin), the 
latter being probably impure scillitoxin. 

Officinal Preparations, U. S. 

Acetum Seillas (10 per ct.). Dose, n\,x-3ss (.65 to 
2. Gm.). 

Syrupus Scillse (Acetum Scillae with sugar). Dose, 
f3ss-j (2. to 4. Gm.). 

Syrupus Scillse Compositus (Tartar emetic gr. f 
and senega and squill, each 30 grs. to the f^j). Dose, gtt. 
x_f'5j (.65 to 4. Gm.). 

Tinetura Seillae (15 per cent.). Dose, n^x-xx (.65 
to 1.30 Gm.). 

Extraetum Seillae Fluidum. Dose, n^ij-iij (.12 
to .20 Gm.).] 

Internal Effects. 

Physiological. Therapeutical. 

In large doses, squill may Squill is never used as an 
act as an emetic, and cause emetic [except in its combi- 



BROOM. 



461 



violent vomiting with purg- 
ing. 



It also stimulates the bron- 
chial mucous membrane, and 
increases the urinary secre- 
tion. 

[Scillitoxin, or scillain, is 
classed among the cardiac 
tonics by Brunton.] 



nation with tartar emetic as 
" Coxe's Hive Syrup" (Syru- 
pus Scillse Compositus), which 
has been given as a depress- 
ing emetic in drachm or half 
drachm doses in spasmodic 
croup. It may be repeated 
at short intervals, until vom- 
iting occurs.] 

It is, however, a good ex- 
pectorant, increasing the 
bronchial secretions, and is 
one of the most universal ad- 
ditions to prescriptions for the 
relief of various chronic lung 
affections, as bronchitis, and 
also in whooping-cough. 

It is also a tolerably effi- 
cient diuretic, only to be used, 
however, when no irritation 
exists about the kidneys. 



SCOPARIUS— BROOM. 

[ The tops of Sarothamnns Scoparivs, Koch (N. 0. Leguminosoz, 
Papilionacece) . 

Local Effects. 
No local action has been described. 



Constitutional Actions. 



Scoparius has some influ- 
ence over the digestive and 
secreting organs, causing, in 
large doses, vomiting and 
purging, but in smaller in- 
creasing very considerably the 
urinary water. Two active 
principles have been extract- 
ed from the drug, regardino; 
whose physiological actions 
some difference of opinion 

39 



Scoparius is an excellent 
diuretic, and is largely used 
for the purpose of removing 
dropsical accumulations. If 
we can succeed in stimulating 
the kidneys effectually by a 
combination of this and other 
drugs, we may hope to hold 
in check and disperse the 
anasarca of cardiac and 
chronic kidney-disease, and 



462 



SCUTELLARIA. 



exists. Thus scopakine is 
believed by one class of ob- 
servers to be the diuretic 
factor in broom-tops, whilst 
others assert that it has no 
such property. Sparteine 
has also been very variously 
described, but the balance of 
testimony goes to show that 
it has very definite toxic 
powers, lowering the reflex 
action of the spinal cord, 
paralyzing the motor nerves, 
suspending the electrical ex- 
citability of the vagus, and 
finally causing death by respi- 
ratory paralysis. 



to aid the removal of the 
watery fluid of hydrothorax 
and ascites. [An infusion of 
scoparius (3j to Oj), in con- 
junction with purging by 
compound jalap powder, is 
often used in cardiac dropsy, 
to relieve an overloaded right 
side of the heart, with mitral 
insufficiency.] 

[Sparteine sulphate is con- 
sidered a cardiac stimulant 
and tonic resembling digi- 
talis, and is recommended by 
See in weak and irregular 
heart in daily dose of .05 to 
.25 Gm.] 1 



Dose and Mode of Administration. 

Scoparius is seldom prescribed alone, but is most usually 
made the basis of diuretic mixtures, on the well-known prin- 
ciples of combination, which is here of essential service. 



R. Potassii acetatis 5\ss ; or 6 

Acetiscillae i'3iv ; " 16 

Decocti scoparii [Br.] q. s. ad f§vj : " 192 

Fiat mistura. Capiat unciaru unam quartis lioris 



]£. Tincturse digitalis ~n\.x ; 

Spiritus petheris nitrosi, 
Spiritus juniperi eomp., aa f3ss 

Succi scoparii [Br.] 15.J '■> 

Aquse q. s. ad fgj ; 

S. Fiat haustus, ter die suniendus. 



Gm. 



65 Gin. 



M. 



M. 



[SCUTELLARIA— SCUTELLARIA (SKULLCAP). 

Scutellaria lateriflora, Linne* (N. 0. Labiatce). 

Officinal Preparation. 

Extraetum Scutellariae Fluidum. Dose, f3s>-j 
(2 to 4 Gm.). 

1 [See Philadelphia Medical Times, vol. xvii. p. 20.] 



SENEUA. 463 

Skullcap has a bitter taste and probably contains a bitter 
principle. The eclectic preparation Scutellaria is an impure 
extract " probably devoid ot medicinal properties. 1 ]" 



SENEGA— SENEGA. 

[ The root of Poly gala Senega (N. 0. Polygalaceoz). 
Dose, in substance, gr. xx (1.30 Gm.). 

Officinal Preparations, U. S. 

Abstraetum Senegae. Dose, gr. v-x (.30 to .65 
Gm.). 

Extraetum Senegas Fluidum. Dose, n^x-xxx 
(.65 to .2 Gm.). 

Syrupus Senegae. Dose, f'5j to ij (4 to 8 Gm.). 

It also enters into Syrupus Scillee Compositus.] 

Local Effects. 
No external or local action has been described. 

Constitutional Actions. 

Physiological. Therapeutical. 

The principal action of Senega is of great service 

senega is that of stimulating in the more chronic condi- 

the mucous membrane of the tions of pneumonia and bron- 

bronchial tubes, and possi- chitis, where it seems to help 

bly, by a tonic influence on the patient to get rid of the 

their muscular tissues, facili- large quantities of secretion 

tating the expulsion of their frequently accumulated 

contents. It has also been within the lungs. Theoreti- 

accredited with diaphoretic, cally at least, its stimulating 

diuretic, and emmenagogue properties would contra-indi- 

properties, but is seldom em- cate its use in the more acute 

ployed in any other capacity pulmonary affections, but in 

than as an expectorant. [The the later stages of bronchitis, 

active principle is senegin or and more especially those 

polygalic acid, which appears cases occurring among the 

to be identical with saponin ; very old, or young, it is of real 

it forms a soapy emulsion with value, 
hot water.] 

1 [Oldberg & Wall, Companion to the U. S. Pharmacopoeia.] 



464 



SENNA. 



Dose and Mode of Administration. 

The infusion is the preparation most commonly employed, 
and it is generally combined with carbonate of ammonium 
and other expectorants. Thus : — 



$. Ammonii carbonatis 
Tincturse scillse 
Tinct. opii camphorat. 
Extracti glycyrrbizse 
Infusi senegae [Br.] 
Fiat haustus ter die sumendus. 



gr. iv ; 


or 




25 


Tt^xv; 


(< 


1 




tt\.xxv ; 


<< 


1 


60 


gr. v; 


cc 




30 


q. s. ad f|j ; 


<« 


32 




endus. 









25 Gm. 



M. 



SENNA—SENNA. 

[The leaflets of Cassia acutifolia, Delile {Alexandria Senna), and of 
Cassia elongata, Lemaire-Lisancourt {India Senna), {N. 0. Legumi- 
nosoz, Cozsalpineoz). 

Officinal Preparations, U. S. 

Confeetio Sennse. Dose, 2>j-ij (4 to 8 Gm). 

Extractum Sennse Fluidum. Dose, f3j-iv (4. to 
16. Gm.). 

Infusum Sennse Compositum (6 per cent.). Dose, 
f^ij_iv (64. to 128. Gm.). 

Syrupus Sennse (33 per cent.). Dose, f 3j-ij (4. to 
8. Gm ). 

Pulvis Glycyrrhizse Compositus (Senna 18, 
licorice 16, fennel 8, washed sulphur 8, sugar 50 parts). 
Dose, f'3j-ij (4 to 8 Gm.). 

It also is one of the constituents of Compound Syrup of 
Sarsaparilla.] 

Internal Effects. 



Physiological. 

Senna irritates the small 
intestine, causing copious, 
thin, yellow evacuations, and 
stimulating the peristaltic 
movements of the bowel. 

" It is an hepatic stimulant 
of very feeble power, render- 
ing the bile more watery." 
(Rutherford.) 



Therapeutical. 

Senna is a most useful 
purgative, ranking among the 
cathartics with slightly dras- 
tic tendencies, and it may be 
prescribed in simple consti- 
pation, in dyspepsia, and in 
a large variety of conditions 
where rapid and effectual 
unloading of the bowels is 
required. 



SERPENTARIA — SUET. 465 



Dose and Mode of Administration. 

Senna is seldom prescribed alone, as it is then apt to 
cause irregular contraction of the intestines and griping. It 
is therefore usually combined either with other purgatives, 
as magnesii sulph. (black draught), or with various aroma- 
tics, as in the confection and compound licorice powder. 

Cassia and tamarinds have both a slightly purgative 
action, but are only used as ingredients in various compound 
preparations, as the confection of senna. [The syrup of senna 
is a good purgative for young children. It makes a good 
emulsion with castor oil.] 



SERPENTARIA— SERPENTARIA (VIRGINIA 
SNAKEROOT). 

[ The rhizome and rootlets of Aristolochia Serpentaria, Linne, and of Aris- 
tolochia reticulata, Nuttall (iV*. 0. Aristolochiacece) . 

Officinal Preparations, U. S. 

Extraetum Serpentariae Fluidum. Dose, gtt. 
xx-xxx (1.30 to 2. Gm.). 

Tinctura Serpentariae (10 per cent.). Dose, f3j-ij 
(4. to 8. Gm.).] 

This drug is probably a bitter tonic, but the other virtues 
with which it has been credited seem to rest on no very 
stable foundation. [It belongs to the class of the aromatic 
bitters, and is a good addition to other tonics, as cinchona, 
and is included in the composition of the popular Huxham's 
tincture — Tinctura Cinchonse Comp.] 



SEVUM— SUET. 

[ The internal fat of the abdomen of Ovis Aries, Linne ( Class Mammalia, 
Order Ruminantia) purified by melting and straining. 

Used only in pharmacy, and as an ingredient in Unguen- 
tum Hydrargyri and Ung. Picis Liquidae. 

An ointment made by adding calomel gr. v— x to suet 3j is 
used with good effect in eczema capitis.'] 



466 



WHITE MUSTARD — BLACK MUSTARD. 



SINAPIS ALBA— WHITE MUSTAED. 

The seed of Sinapis alba, Linne (Brassica alba, Hooker films et 
Thompson) (N. 0. Cruciferce, Siliquosoz). 

SINAPIS NIGRA— BLACK MUSTARD. 

The seed of Sinapis nigra, Linn6 {Brassica nigra, Koch), 
(iV. 0. Cruciferoz, Siliguosce). 

Officinal Preparations, U. S. 

Chartae Sinapis. Mustard papers (4 inches square). 

Oleum Sinapis Volatile. External use. 

Linimentum Sinapis Compositum (Vol. oil of 
mustard 3, ext. mezereum 2, camphor 6, castor oil 15, alco- 
hol q. s. ad 100). External use. J 

Local Actions. 



Physiological. 

Mustard applied to the 
skin causes a vivid redness, 
with violent smarting and 
itching, and, if the applica- 
tion be continued too long, 
vesication may follow, and 
even troublesome ulceration. 

[This is said not to happen 
when mustard papers are used, 
or when tissue paper is placed 
on the front of the poultice.] 



2. [The irritation of the 
peripheral extremities of the 
sensory nerves in the skin by 



Therapeutical. 

Mustard is used, first, for 
the relief of pain, and there 
can be no doubt that benefit 
is thus derived in many ner- 
vous, rheumatic, and inflam- 
matory affections. In neural- 
gia, lumbago, sciatica, pleu- 
rodynia, pleurisy, pneumo- 
nia, peritonitis, colic, and a 
vast variety of painful dis- 
orders, we may expect to 
alleviate suffering in some 
measure by the use of sina- 
pisms, and at other times we 
use this mode of drawing 
blood to the surface, and so 
relieving the congestion of 
deeper parts, on the principle 
referred to under the heading 
of "Counter-irritation." 

2. Mustard poultices are 
most valuable in arousing pa- 
tients from the dangerous co- 



BLACK MUSTARD. 



467 



the action of the volatile oil, 
is reflected to the centres 
from which these nerves arise, 
producing revulsive effects ; 
and, by reflex action through 
the vaso-motor nerves, it thus 
influences the conditions of 
vascularity and nutrition of 
adjacent organs, the brain or 
the lungs, for instance.] 



matose condition into which 
they occasionally drift in the 
course of some of the acute in- 
flammations ; and sinapisms 
applied to the feet and calves 
are of service in the stupor 
of narcotic poisoning and in 
urcemic coma. 



Mustard baths may be em- 
ployed tobringback the erup- 
tion of some abortive cases 
of the exanthemata, or as a 
stimulant in acute bronchitis, 
or in the convulsions of chil- 
dren. 



Constitutional Actions. 



Physiological. 

Digestive Organs Mus- 
tard increases the appetite by 
irritating the mucous mem- 
brane of the stomach, but 
does not increase the secre- 
tion of gastric juice. 

It acts as a prompt and 
effectual emetic of the direct 
class. 



Therapeutical. 

Mustard is extensively 
used as a dietetic condiment. 



This emetic power is of 
great value in cases of poison- 
ing, as mustard is always at 
hand, and can be used at 
once. 



Mode of Administration. 
A mustard poultice must be made with cold water, for we 
know that hot water dissipates the volatile oil on which the 
counter-irritation depends, vinegar destroys it, and alcohol 
prevents its formation. It must be kept on from twenty 
minutes to half an hour, according to circumstances. [Very 
strong mustard may have too much effect upon tender skins, 
and it should always be mixed with flour or starch for 
children.] 



468 sodium. 



SODIUM. 



[Officinal Preparations, U. S. 

Soda. Caustic Soda. 

Liquor Sodae (4 per cent.). Dose, well diluted, n^v-x 
(.30 to .65 Gm.). 

Sodii Acetas. Acetate of Sodium. Dose, gr. v-xl 
(.30 to 2.60 Gm.). 

Sodii Benzoas. Benzoate of Sodium. Dose, gr. x-xx 
(.65 to 4. Gm.). 

Sodii Bicarbonas Venalis. (Used in making Sodii 
Bicarbonas.) 

Sodii Boras (Borax). Dose, gr. x-xl (.65 to 2.60 Gm.). 

Sodii Bromidum. Dose, gr. xx-ix (1.30 to 4. Gm.). 

Sodii Carbonas. (Used in making Aluminii Sulphas, 
Bismuthi Subnitras, Bismuthi Subcarbonas, Calcii Carbonas 
Paecipitatus, Ferri Subcarbonas, Liquor Sodae, Liquor Sodae 
Cliloratae, Massa Ferri Carbonatis, Pilulae Ferri Com- 
positae, Potassii et Sodii Tartras, Sodii Carbonas Exsiccatus, 
Sodii Phosphis, and Zinci Carbonas Praecipitatus.) (Wash- 
ing Soda) gr. v-xx (.30 to 1.30 Gm.). 

Sodii Chloridum (table-salt). (Used in making Calomel 
and Corrosive Sublimate.) Dose, gr. x-5j (.65 to 4. Gm.). 

Sodii Chloras. Dose, gr. ij-x (.13 to .65 Gm.). 

Sodii Hypophosphis. Dose, gr. x-xx (.65 to 1.30 
Gm.). 

Syrupus Hypophosphitum (see page 211). 

Sodii Hyposulphis. Dose, gr. x-xx (.65 to 1.30 
Gm.). 

Sodii Iodidum. Dose, gr. x-xl (.65 to 2.60 Gm.). 

Sodii Nitras. Gr. xx-3ij (1.30 to 8 Gm.). 

Sodii Sulphas. Glauber's Salt. Dose, ^ss-j (16. to 
32. Gm.). (Also used in making Sodii Carbonas.) 

Sodii Bisulphis. Dose, gr. x-3ss (0.65 to 2. Gm.). 

Sodii Sulphis. Dose, gr. xx to 3j (1.30 to 4 Gm.). 

Sodii Arsenias. Dose, gr. y^-J (.005 to .02 Gm.). 
Liquor Sodii Arseniatis. Dose^iij-v (.20 to .30 Gm.). 

Sodii Bicarbonas. (Baking Soda.) Dose, gr. v-x 
(.30 to 4. Gm.). 

Mistura Rhei et Sodae. (See Rhubarb.) 

Pulvis Effervescens Compositus. (See page 470.) 

Trochisci Sodii Bicarbonatis (aa 3 grains). 



sodium. 469 

Sodii Carbonas Exsieeatus. (Used in making 
Sodii Arsenias.) Dose, gr. ij-x (.13 to .65 Gm.). 

Sodii Phosphas. Dose, as a cholagogue, gr. xx-xl, 
or as a purgative, 3j-ij (1-30 to 64. Gm.). (Used in making 
Ferri Phosphas and Ferri Pyrophosphas.) Dose, gr. v-^j 
(0.30 to 30. Gm.). 

Liquor Sodae Chloratse. Labarraque's Solution, 
Dose, t-3ss-j (2. to 4. Gm.), well diluted. 

Sodii Pyrophosphas. Dose, gr. v-xl (0.30 to 2.60 
Gm.). 

Sodii Salieylas. Dose, gr. x-5j (.65 to 4 Gm.). 

Sodii Santoninas. Dose, gr. ij-x (.13 to .65 Gm.). 

Troehisei Sodii Santoninatis (aa gr. j). Dose, 
1 to 5. 

Liquor Sodii Silieatis. (Soluble glass.) External 
use. 

Sodii Sulphocarbolas. Dose, gr. ij-v (.13 to .32 
Gm.). 

Poisoning. 

Soda is a corrosive mineral poison, and its symptoms and 
morbid appearances are analogous to those following the use 
of potassa. 

Tests. 

Caustic soda in solution is not precipitated by bichloride 
of platinum, or by tartaric acid ; its alkaline nature can be 
ascertained by the usual tests. Antimoniate of potassium 
affords a white precipitate when added to the salts of soda. 
Soda tinges the outer flame of the blowpipe yellow. 

Antidotes. 
The same as for potassa.] 

Effects and Uses. 

The sodium salts have none of the depressing action on the 
heart which we have seen to be possessed by potash. 

Locally, we may use soda in acute eczema ; or the hypo- 
sulphite in parasitic skin disease, where it acts in virtue of 
the contained sulphurous acid-, and the borate, or borax, 
as a gargle, as a lotion in pruritus and various skin diseases, 
40 



470 SODIUM. 

and as an application to aphthous ulcerations about the 
mouth. 

A saturated solution of carbonate of sodium is said to be 
a very soothing application in burns. [It must be applied 
cold, and, therefore, is not well adapted to cases where a 
large area is injured, but it may be applied freely in the dry 
form of the bicarbonate.] The internal use of borax occa- 
sionally causes an eruption of psoriasis curable by arsenic. 

Soda is not so much used internally as a remedy for gout 
and rheumatism, because the urate of soda is less soluble 
than the urate of potash ; but it is one of our best remedies 
in those forms of dyspepsia with pain after food, weight at 
the stomach, red fissured tongue, cough, and palpitation. 
The hyposulphite is useful in sarcinous vomiting, and some 
physicians have faith in the hypophosphate as a nervine 
tonic. 

[The bicarbonate is a remedy of value in irritability of 
the bladder. It is also frequently used in combination with 
syrup of rhubarb in catarrhal jaundice.~\ 

Sodium chloride is a good emetic ; the phosphate and tar- 
trate are purgative, but none of the preparations appear to 
be decidedly diuretic in their action. Sodium phosphate 
was found by Rutherford to be a powerful stimulant of the 
liver, whilst sodium sulphate possessed the same action, in 
a less degree. 



Seidlitz Powder. 


(Pulvis Effervescens 


situs.) 




I£. Potassii et sodii tart. 5U 5 or 8 
Sodii bicarbonatis gr. xl ; " 2 

Misce, ut fiat baustus effervescens cum 

Acidi tartarici gr. xxxv ; " 2 
Aquse fgiv; " 128 



Gm. 



Statim sumendus. 



[To be kept in separate papers until just before using, 
when each is to be dissolved in half a tumblerful of water ; 
the solutions are then mixed and drunk at once. 

In cases of obstinate vomiting with constipation, broken 
doses of Seidlitz powder given frequently are useful, say 
^ of each powder in an ounce of water, given, whilst efferves- 
cing, every fifteen minutes. Impaction of feces may often be 
overcome by frequent doses of these powders.] 



1 


30 Gm. 


] 


30 " 


2 


«< 


32 


u 



PINKROOT. 471 

I£. Sodii bicarbonatis gr. xx ; 

Tinct. calumbse "n\xx ; 

Syrupi zingiberis f3 ss 5 

Infusi gentianse compositi q. s. ad i'3J ; 
Misce, ter die sumetid. 

Useful draught in dyspepsia. 

[The following is a pleasant antacid combination, known 
as: — 

Soda-Mint. 



I£. Sodii bicarbonatis, 

Sacchari, aa ^ij ; or 8 

Spiritus ammoniae aromatici ""1x1; " 2 

Aqua? menthse piperita? q. s. ad f^vhj 5 " 256 

M. S. Dose, a tablespoonful after meals. 



Gm. 

60 " 



Used in flatulent dyspepsia. It admits of the addition of 
tincture ofnux vomica, or syrup of rhubarb. 

Compressed pills of soda-mint, for making the solution 
extemporaneously, may also be obtained from druggists.] 



[SPIGELIA—PINKROOT. 

The rhizome and rootlets of Spigelia Marilandica, LinnJ (N. 0. 
Loganiaceoz) . 

Dose, in substance, 3j (4. Gm.). 

Officinal Preparation. 

Extr actum Spigelian Fluidum. Dose, f3j-ij (4. 
to 8. Gm.). 

Spigelia is an efficient remedy against the round worms, 
or lumbricoidS) and in moderate doses is entirely safe; but 
in overdoses has narcotic properties. It is given in infusion 
or syrup, morning and evening, for two or three days, fol- 
lowed by a brisk cathartic. An objection to the use of 
spigelia is that it imparts its red color to the clothing. It is 
best given with a cathartic, as in the " Extractum Spigeliae 
et Sennse Fluidum," U. S. 1870, the proportions being f^x 
of the former to f Jvj of the latter, with oil of anise and oil 
of caraway, each n^xx. Dose, for a child two years old, 
f 5ss-j (2 to 4 Gm.).] 



472 WHISKY — STAPHISAGRIA. 

[Spiritus. 

List of Spirits officinal in the U. S. P. : — 

Spiritus iEtheris Spiritus Gaultheriae 

" " Compositus " Juniperi 

" " Nitrosi " " Compositus 

" Ammonise " Lavandulae 

" " Aromaticus " Limonis 

" Anisi " Mentha? Piperita? 

" Aurantii " " Viridis 

" Camphorae " Myrciae 

" Chloroformi " Myristicae 

" Cinnamorai " Odoratus 

" Frumenti " Vini Grallici.] 



[SPIRITUS FRUMENTI—WHISKY. 

An alcoholic liquid obtained by the distillation of fermented grain {usually 
corn, wheat, or rye) , and at least two years old. ] 



[SPIRITUS VINI GALLIC!— BRANDY. 

holic liquid obtained by the distillation of 
least four years old. 

For effects and uses, see Alcohol.] 



An alcoholic liquid obtained by the distillation of fermented grapes, and at 
least four years old. 



STAPHISAGRIA— STAPHISAGRIA (STAVES- 
ACRE). 

[The seed of Delphinium Staphisagria, Linn4 (iV. 0. Ranunculaceoz) .] 

The ointment of stavesacre [crushed seeds one part, 
benzoinated lard two parts, P. Br.] is an effectual and un- 
irritating cure for scabies. 

[It is said to possess diuretic, cathartic, and emetic pro- 
perties. In prurigo, it has been used externally with suc- 
cess. Its principal use is for destroying vermin. 

The seeds contain several alkaloids, the most important 
being delphinine and staphisagrine, the first resembling 
aconite in its effects, the latter acting like curare; both 
cause death by asphyxia. Brunton.] 



STILLINGIA — STRAMONIUM SEED. 473 

[STILLINGIA— STILLINGIA (QUEEN'S ROOT). 

The root of Stillingia sylvatica, Linne (2V. 0. Euphorbiacece) . 
Dose, in substance, gr. xx (1.30 Gm.). 

Officinal Preparation, U. S. 

Extraetum Stillingia? Fluidum. Dose, n^xx-xxx 
(.130 to 2. Gm.). 

Stillingia is highly esteemed as an alterative in secondary 
syphilis, skin disease, and scrofula. In large doses it is 
emetic and cathartic. As an alterative, it is frequently given 
in combination with sarsaparilla. A decoction (3j to Oiij 
boiled to Oj), dose, f'^j-ij (32. to 64. Gm.) ; and a tincture 
(Jij to Oj), dose, f5j (4. Gm.), are largely used in the South, 
but are not officinal.] 



[STRAMONII FOLIA—STRAMONIUM LEAVES. 

The leaves of Datura stramonium, Linne" (2V. 0. Solanaceoz). 
No Officinal Preparation. 



STRAMONII SEMEN—STRAMONIUM SEED. 

The seed of Datura stramonium, Linne* (2V. 0. Solanaceoz). 

Officinal Preparations, U. S. 

Extraetum Stramonii. Dose, gr. J-i (.015 to .03 
Gm.). 

Unguentum Stramonii (extract 10 per cent). Ex- 
ternal use. 

Extraetum Stramonii Fluidum. Dose, ny-ij (.06 
to .13 Gm.). 

Tinctura Stramonii (10 per cent.). Dose, ni^x-xx 
(.65 to 1.30 Gm.). 

Antidotes. 

The same as for belladonna-poisoning. See page 195.] 

After the careful description already given of the actions 
and uses of belladonna, it is unnecessary to say much about 

40* 



474 STRYCHNINE — SUBLIMED SULPHUR. 

stramonium. Modern investigation has shown that the active 
principle, daturine, is identical with atropine ; and the only 
marked difference between the two plants seems to consist 
in the more decided antispasmodic properties of stramonium, 
which cause it to be much prized as a remedy for asthma. 
In the purely spasmodic varieties of that disease, and most 
efficiently when inhaled in the form of smoke, it seldom fails 
to give relief. [The ointment is used for hcemorrhoids.~\ 



STRYCHNINA—STRYCHNINE. 

An alkaloid prepared from Nux Vomica or Ignatia, and also occurring in 
other plants of the Nat. Ord. Loganiaceoz. 

[See Nux Vomica.] 



[STYRAX— STORAX. 

A balsam prepared from the inner bark of Liquidambar orientalis, 
Miller (iV. 0. Hamamelaceoz , Balsamijiwe) . 

Tinctura Benzoini Composita. External use. 

Storax has been recommended as a substitute for copaiba 
in the treatment of gonorrhoea and gleet; and mixed with 
olive oil, equal parts, is effectual in the treatment of scabies. 
It is ranked as a stimulating expectorant, but is chiefly used 
as an ingredient in the compound tincture of benzoin.] 



SULPHUR SUBLIMATUM— SUBLIMED SULPHUR. 

S ; 32. 

A fine citron yellow powder, slight odor, faintly acid taste, insoluble in 
water or alcohol. 

(Flowers of Sulphur.) Dose, 3J-iij (4 to 12 Gm.). 

Officinal Preparations. 

Sulphur Lotum. Sublimed sulphur, thoroughly 
washed with water. Dose, 3j-ij (4 to 18 Gm.). 

Pulvis Glyeyrrhiz® Compositus. (See Senna.) 
Unguentum Sulphuris (sublimed sulphur 30 parts, 
benzoinated lard 70 [tarts). 

Sulphuris Iodidum. Not used internally. 



SUBLIMED SULPHUR. 415 

Sulphur Praecipitatum. Precipitated sulphur. Dose, 
3j-iij (4 to 12 Gm.). 

Unguentum Sulphuris Alkalinum (washed 
sulphur 20 parts, carbonate of potash 10 parts, water 5 
parts, benzoinated lard Qo parts). 

The officinal Sulphites are : — 

Sodii Hyposulphis. 
Sodii Sulphis. 
Sodii Bisulphis. 
Potassii Sulphis. 
Magnesii Sulphis. 

Sublimed sulphur is used in making Emplastrum Ammo- 
niaci cumHydrargyro. (For sulphates see Acid Sulphuric). 

The officinal Sulphides are : 

Calx Sulphurata (commonly misnamed Sulphide of Cal- 
cium, but of which it contains 36 per cent.). Antimonium 
Sulphuratum (which is chiefly Antimonious Sulphide with 
a very small amount of Antimonious Oxide). Antimonii 
Sulphidum, Antimonii Sulphidum Purificatum, and Potassa 
Sulphurata which contains at least 5Q per cent, of true 
Sulphide of Potassium.] 

External Use. 

Sulphur is used externally as a stimulant in various forms 
of chronic skin disease, such as acne faciei, and more espe- 
cially in itch, a disease dependent on the presence of a 
minute insect, the acarus scabiei, the male of which ranges 
freely over the skin, whilst the female retires with her eggs 
to oblique burrows in the cuticle. These receptacles having 
been broken up by soap and water, sulphur ointment is care- 
fully spread over all the patient's body at bed-time, and 
washed away by a warm bath next morning. Two or three 
applications of this sort are sufficient to cure the disease, and 
if the patient's skin will bear the unguentum sulphuris, one 
smearing with this may be sufficient. The rationale of the 
treatment is, not that sulphur acts as a direct poison to the 
acarus, but that it forms with lard a very tenacious and 
adhesive substance, which suffocates the insect by blocking 
up its air-pores. [The sulphur ointment should generally be 
diluted with cerate, ^ to |; otherwise it may produce too 
great irritation.] 



476 



SUBLIMED SULPHUR. 



Sulphur is also in great favor as a popular remedy for 
rheumatism, sprinkled on new flannel and applied to the 
painful part, and there is no doubt that some beneficial 
action may thus be caused. Lastly, sulphur makes a useful 
bath in some forms of chronic skin disease. 



Internal Use. 
Physiological Action. Therapeutical Action. 



1. It has been supposed to 
exert a stimulating influence 
on the mucous membranes 
and skin. 



1. In virtue of this, it used 
to be occasionally prescribed 
in chronic bronchitis and 
phthisis, and also used ex- 
ternally in skin diseases. To 
its action on the skin may be 
attributed its undoubted 
power of aiding — more espe- 
cially in the form of bath — 
the elimination of lead and 
mercury from the system. 
Sulphur has lately been re- 
commended as the best means 
of preventing mercurial sali- 
vation. 

2. It acts, therefore, as a 
gentle laxative, slightly soft- 
ening the feces, and from 
the mildness of the action it 
is specially useful in piles 
and all irritable conditions 
about the rectum. Its pur- 
gative action is increased by 
its being dissolved and formed 
into a sulphide by the alkali 
of the bile. 

3. Burnt in a room with 
closed doors and windows, it 
is the best way to remove the 
germs of infection from the 
air by fumigation. 

Sulphur is given off from the system principally by the 
bowels, but also by the milk, the sweat, and the skin, in the 



2. It causes slight increase 
of the peristaltic movements 
of the bowels. 



3. Sulphur has well-marked 
antiseptic properties in con- 
sequence of its destructive 
power over the lower forms 
of vegetable life. 



SUMBUL. 47? 

form of sulphuretted hydrogen, and by the urine as a sul- 
phate. 

Strong applications of sulphur frequently irritate the skin, 
and bring on troublesome eczema. The disadvantage of 
sulphur as an aperient is the offensive odor which the sul- 
phuretted hydrogen communicates to the feces. 

The confection [Br.] is the best purgative form [con- 
taining sulphur §iv, and cream of tartar ^j, in syrup of 
orange-peel fj|iv], in tea- or table-spoonful doses. 

[The sulphites have been recommended by Polli in 
drachm doses for pyaemia and septicaemia, but more extended 
experience declares them to be worthless for this condition. 
The sulphite or the hyposulphite of soda is sometimes given 
in yeasty or sarcinous vomiting to prevent fermentation.] 



[SUMBUL— SUMBUL. 

The root of Ferula Sumbul, Hooker filius (iV. 0. Umbelliferos, 
Orthospermce'). 

Dose, gr. x-lx (.65 to 4. Gm.). 

Officinal Preparation. 

Tinetura Sumbul (10 per cent.). Dose, 3«s-j (2 to 
4 Gm.). 

Musk-root contains a volatile odorous oil, angelicic and 
valerianic acids, some soft resin, etc. It may be used in 
chronic bronchitis, leucorrhoea, etc., in doses of gr. 8-60 
(.05 to 4. Gm.). The tincture may be given in hysteria.~\ 



Suppositoria. 

For officinal formula for Suppositories, see under Oleum 
Theobromine, page 388. There are no officinal Supposi- 
tories in the edition of the Pharmacopoeia of 1880.] 



478 TOBACCO. 

[Syrupi. 

The officinal Syrups are — 

Syrupus Acacias Syrupus Kramerise 

" Acidi Citrici " Lactucarii 

" " Hydriodici " Limonis 

" Allii " Picis Liquid* 

" Althaese " Pruni Virginianae 

" Amygdalae " Rhei 

" Aurautii " " Aromaticus 

" Florum " Rosas Gallicas 

" Calcii Lactopkosphatis " Rubi 

" Calcis " " Idasi 

" Ferri Bromidi " Sarsaparillas Comp. 

" " Iodidi " Scillae 

" " Quininse et " " Compositus 

Strychninas Phospha- " Senegas 

turn " Sennas 

" Hypophosphitum " Tolutanus 

" " cum Ferro " Zingiberis.] 
" Ipecacuanhas 



TABACUM— TOBACCO. 

[ The commercial dried leaves of Nicotiana Tabacum, Linnt 
(iV. 0. Solanacece). 

Officinal Preparations, U. S. 

Infusum Tabaci (5j to Oj). Dose, f$ij (8. Gm.). 
Oleum Tabaci. Not used internally. 
Unguentum Tabaci. (Watery extract of leaves 3j 
to 3 xv j of lard.) 

Vinum Tabaci. Dose, gtt. v-xx (.30 to 1.30 Gm.). 

Antidotes. 

Strychnine and diffusible stimulants may be regarded as 
physiological antidotes to tobacco ; and after thoroughly 
washing out the stomach, tincture of digitalis may be ex- 
hibited to counteract the depressing influence of the poison 
on the heart, and the tendency to collapse. Respiration 
should be stimulated by ammonia, frictions, and even main- 
tained artificially. Sulphate of strychnine may be given 
hypodermically, and stimulating enemata injected.] 



TOBACCO, 



479 



Effects and Uses. 

Tobacco is now rarely, if ever, used internally in medi- 
cine, on account of its poisonous properties; but it is a sub- 
stance in such general domestic use, and therefore of so 
great physiological interest, that we must devote some little 
space to considering the results of modern experiment on its 
action. 



Local 

Physiological. 

Tobacco is readily absorbed 
by the skin, and symptoms 
of poisoning have followed 
the application of strong infu- 
sions to the unbroken cuticle. 



Action. 

Therapeutical. 

Tobacco has been used as 
a local application in prurigo 
and other skin diseases, but 
is too readily absorbed to de- 
serve recommendation for this 
purpose. 



Internal Action. 



1. Brain and Nervous Sys- 
tem The brain seems to be 

little affected, but some ex- 
citement of the spine is an 
early symptom of the poison- 
ous action of the drug, speedily 
followed, however, by mus- 
cular relaxation and paralysis, 
also of spinal origin. 

The sensory nerves are not 
affected, but we find lowering 
of the functional activity of 
the motor nerves. The pupil 
is contracted. 

The use of tobacco is be- 
lieved to have some injurious 
effect on vision ; and Hutch- 
inson and others have re- 
corded instances of atrophy 
of the optic nerve and total 
blindness thus produced. 

Amblyopia and color blind- 



1. Before the introduction 
of chloroform, advantage was 
taken of the depressing and 
relaxing influence of tobacco 
on the muscular system to 
employ the enema in stran- 
gulated hernia and disloca- 
tions. Any occasional suc- 
cess, however, was amply 
counterbalanced by the in- 
conveniences and even dan- 
gers which too often resulted ; 
and this application of the 
drug has now fallen into well- 
merited oblivion. 

In consequence of its low- 
ering action on the reflex 
function of the spinal cord, 
it has been proposed as a 
remedy for tetanus and an 
antidote for strychnine-poi- 
soning. 



480 



TOBACCO. 



ness are not uncommon in 
smokers. 

[It is claimed that these 
effects are more apt to follow 
from the combined action of 
tobacco and alcohol than 
from tobacco alone.] 

2. Circulation and Respi- 
ration It is not necessary 

for us to go into the elaborate 
and contradictory series of 
experiments made to prove 
the fact that tobacco is a 
powerful depressant of the 
heart's action. The temper- 
ature usually falls in tobacco- 
poisoning, and death ensues 
from respiratory paralysis. 
[Excessive use of tobacco 
produces functional disorder 
of the heart, which may result 
in hypertrophy, dilatation, 
and organic disease.] 

3. Digestive and Secreting 

Organs Tobacco usually 

causes nausea and vomiting, 
as most smokers can testify ; 
but toleration is soon estab- 
lished, and even considerable 
doses then fail to disturb the 
equanimity of the digestive 
organs, save a slightly pur- 
gative action on the bowels. 
It is stated, however, that 
in habitual smokers some 
symptoms of dyspepsia may 
be detected, indicated by 
furred tongue and loss of ap- 
petite ; and there is also some 
generally diffused, granular 
irritation about the pharynx. 



2. Tobacco -smoking has 
been known to give relief 
in asthma and chronic bron- 
chitis. 



3. Moderate smoking, as a 
rule, aids digestion, by acting 
as an aperient. [The post- 
prandial cigar is thought to 
aid digestion by confirmed 
smokers, and tends to increase 
either the peristalsis or secre- 
tions of the intestine, or both. 
In chronic constipation Bar- 
tholow advises small doses of 
the wine of tobacco to be 
added to a laxative combina- 
tion, given at night.] 



TAMARIND — DANDELION. 481 



[TAMARINDUS— TAMARIND. 

The preserved pulp of the fruit of Tamarindus Indica, Linni 
(N. 0. Leguminosce, Ccesalpiniece) . 

Tamarinds are laxative, and are used in making a re- 
frigerant drink for the sick. They enter into the Confectio 
Senna, U. S. P.] 



[TANACETUM— TANSY. 

The leaves and tops of Tanacetum vulgare, Linne (N. 0. Compositce). 

Tansy contains a bitter principle, tanacetin, and some 
volatile oil. It is carminative, and has been employed as an 
emmenagogue in doses of gr. j-iij (.06 to 20. Gm.). The 
oil is sometimes taken with the object of causing abortion, 
but in this it rarely succeeds, while it may cause violent in- 
testinal irritation, ending in death.] 



TARAXACUM—DANDELION. 

\_The root of Taraxacum Dens-leonis, Desfontaines (N. 0. Compositoz), 
gathered in autumn. 

Officinal Preparations, U. S. 

Extractum Taraxaci. Dose, gr. xx-xxx (1.30 to 
2. Gm.). 

Extractum Taraxaci Fluidum. Dose, f3j-ij (4. 
to 8. Gm,).] 

Taraxacum is usually prescribed as a matter of routine in 
sluggish liver, and the various forms of dyspepsia depending 
on a supposed deficiency of bile ; but, although it may have 
some mild tonic, diuretic and aperient properties, there is 
not the slightest evidence for asserting that it exerts any 
real influence over the hepatic functions. 

I£. Succi taraxaci [Br.] f ^j ; 

Acidi nitro-muriatici dil. "n|x ; 

Tincturae lupulinae tt^xx ; 

Aquae q. s. ad fjj ; 

S. Ter die sumend. 

41 



4 


Om 




65 " 


1 


30 " 


32 


<( 



482 TURPENTINE — OIL OF TURPENTINE. 



TEREBINTHINA— TURPENTINE. 

[A concrete oleo-resin obtained from Pinus palustris, Michaux, and J 
other species of Pinus (N. 0. Coniferce) .] 



rom 



[TEREBINTHINA CANADENSIS— CANADA 
TURPENTINE (BALSAM OF FIR). 

A liquid oleo-resin obtained from Abies balsamea, Marshall 
(N. 0. Coniferce). 

Turpentine enters into Emplastrum Galbani, and Canada 
Turpentine into Cliarta Cantharidis, Emplastrum Ferri and 
Collodium Flexile.] 



[OLEUM TEREBINTHINiE— OIL OF 
TURPENTINE. 

A volatile oil distilled from Turpentine. 

Dose of oil of turpentine n^x— xx (.65 to 1.30 Gm.), 
iven 3 or 4 times daily, in typhoid fever, or chronic dys- 
ntery ; or f5j to f^ss (4. to 16. Gm.) as a vermifuge. 



Officinal Preparation, U. S. 



Linimentum Terebinthinae (Resin Cerate 65 parts, 
Oil of Turpentine 35). Used as a counter-irritant. 

Turpentine enters into Linimentum Cantharidis.] 

Local Action. 
Physiological. Therapeutical. 

Turpentine, when applied This effect of turpentine 
to the skin, causes redness, causes it to be much used as 
tingling, and irritation, lead- a counter-irritant in those 
ing on to acute inflammation cases where we wish to re- 
and blistering, if not removed lieve congestion of internal 
within a limited period. organs by driving the blood 

to the surface. Thus, in 
peritonitis t pneumonia, bron- 
chitis, and asthma, it is fre- 
quently employed, either 






OIL OF TURPENTINE. 



483 



Constitution 
Physiological. 

1. On the Brain.. — Tur- 
pentine produces, in large 
doses, giddiness, and other 
symptoms somewhat resem- 
bling alcoholic intoxication, 
and even ending in coma in 
rare instances. 

2. Circulation Turpen- 
tine acts at first as a stimulant 
to the heart, and has un- 
doubted astringent proper- 
ties, partly, no doubt, from 
its coagulating influence on 
the albumen of the tissues, 
but also by causing contrac- 
tion of the smaller vessels. 



3. Digestive and Secreting 
Orga?is. — Turpentine is dis- 
tinctly irritating to the ali- 
mentary canal, frequently 
causing vomiting and diar- 
rhoea, and it has the. property 
of checking mucous secre- 
tions from the various canals. 

It is also a very certain 
diuretic of the stimulating 
class, but must be used with 
caution, as it is apt to cause 
frequent and painful mictu- 
rition with bloody urine, and 
eventful suppression of the 
secretion [strangury], and 
acute inflammation of the 



sprinkled on hot flannel, or 
in the form of theLinimentum 
Terebinthinas of the Pharma- 
copoeia. 

al Actions. 

Therapeutical. 

1. [Turpentine is a valua- 
ble stimulant in low fevers, 
where the kidneys are not 

diseased.] 



2. As an astringent, tur- 
pentine is valuable in various 
forms of hemorrhage, but 
more especially in that from 
the kidney and in purpura 
hemorrhagica [but is now 
rarely used as a haemostatic, 
oil of erigeron Canadense, 
ergot, and the mineral astrin- 
gents being more reliable, 
and less irritating]. 

3. Turpentine is a valua- 
ble astringent in some forms 
of diarrhoea, and more espe- 
cially that which results from 
the later and ulcerative stage 
of enteric or typhoid fever. 
It is highly recommended in 
the same disease by some 
authorities when abdominal 
pain and distension coincide 
with a raw, clean, dry tongue, 
and in ordinary tympanites 
it makes a good addition to a 
purgative enema. It has been 
recommended by Dr. King 
Chambers as an enema in 
sciatica, where it is supposed 



484 



OIL OF TURPENTINE. 



kidneys. It is therefore well 
to insist on any one using it 
internally to drink freely of 
bailey water or other diluent 
fluids, and not to take a dose 
within three hours of going 
to bed. 



to act locally on the affected 
nerve, which, at one part of 
its course, lies directly in 
contact with the large intes- 
tine ; and it has long enjoyed 
a well-deserved reputation of 
an anthelmintic in cases of 
tape-worm. 

Turpentine has also been 
given in small doses to check 
the excessive secretion in 
some forms of bronchitis, 
and it may also be of service 
in chronic cystitis, gleet and 
pyelitis. 

It has also been used with 
alleged success, though it 
is difficult to see on what 
principle, in iritis, and Dr. 
Crocker praises it highly in 
psoriasis. 



Mode of Elimination. 

Turpentine is rapidly absorbed into the blood, and as 
quickly passes out, principally by the lungs and kidneys, 
imparting to the urine a peculiar violet odor. 

[Old oil of turpentine is considered an efficient antidote 
against phosphorus-poisoning.] 



Dose and Mode of Administration. 



$■ 



S. 



Olei terebinthinse 
Mudlaginis acacise 
Misturse amygdalae, 
Aquae laurocerasi [Br.], 
f3j pro dosi quartis horis. 

Olei terebinthinse 
Mucilaginis 
Ter die sumendus post cibum. 

In psoriasis. 

A few drops of the oil may be given on a lump of sugar, 
in hemorrhage. It is also very conveniently given in perles 
or capsules. 



f5J ; 

aa f§ss 



TT\,X 



Gm. 



m; 



THUJA — THYMOL. 485 

As an anthelmintic, half an ounce may be prescribed 
[combined with an ounce of castor oil, and is very effective 
against rou nd worms as well as teenies']. 



[THUJA— THUJA (ARBOR VITJE). 

The fresh tops of Thuja occidentalism Linne (N. 0. Coniferoz). 

The Arbor Vitae is balsamic; its principal constituent is a 
volatile oil. It contains pinipicrin, sl bitter amorphous 
substance, which alsoexistsin the leaves of Pinus Sylvestris, 
and a yellow substance, thujin. Externally, the fresh leaves 
have been used, rubbed up with lard, as an application to 
indolent ulcers and to condylomata. Internally, thuja has 
been given for intermittent fever, rheumatism, and amenor- 
rhcea, also in chronic catarrh and bronchorrhosa.'] 



THYMOL—THYMOL. 
[C 10 H 13 HO; 150. 

Nearly colorless crystals, with thyme-like odor, pungent 
taste and neutral reaction. Soluble in 1200 parts of water, 
or one part of alcohol at 15° C. (or 59° F.) It liquefies 
with camphor. Sp. grav. 1.028 as a solid ; when fused it is 
lighter than water. It should be quite free from carbolic 
acid.] 

This is an excellent antiseptic, less powerful than car- 
bolic acid, but ten times less poisonous, and much less irri- 
tating. 

Prof. Volkmann has used it instead of carbolic acid in car- 
rying out Prof. Lister's antiseptic plan, and recommends 
the following solution : — 

Gm. 



M. 



It has also been found a good application in eczema and 
psoriasis, and ringworm. 

41* 



$. Thymolis 


gr. xv ; 


or 


1 


Alcoholis 


3ijss; 


" 


10 


Glycerini 


3^; 


(< 


20 


Aquee 


Oij; 


a 


1000 


To be used as a spray. 









486 



TINCTURES 



[The glycerite of thymol diluted with water makes an ex- 
cellent mouth -wash : — 



3- 


Thymolis 


gr. xviij ; or 1,2 Gm. 




Gl.ycerini, 








Alcoholis, 


aa 5 v ijss ; 


30 " 




Aquae destillat. 


s xvi J ; 


" 540] " M.] 




[Tincturae. 




The 


officinal Tinctures are — 




Tinctui 


'a Aconiti 


Tinctura 


Humuli 


c< 


Aloes 


it 


Hydrastis 


" 


-" et Myrrha? 


tt 


Hyoscyami 


(< 


Arnicae Florum 


" 


Ignatiae 


" 


" Radicis 


<( 


Iodi 


(I 


Asafcetida? 


(< 


Ipecacuanha? et Opii 


a 


Aurantii Amari 


a 


Kino 


" 


" Dulcis 


tt 


Krameria? 


(( 


Belladormae 


(< 


Lavandula? Composita? 


it 


Benzoini 


(( 


Lobeliae . 


" 


" Composita 


" 


Matico 


(( 


Bryonia? 


a 


Moschi 


u 


Calendula? 


(( 


Myrrha? 


(( 


Calumba? 


n 


Nucis Vomicae 


tt 


Cannabis Indica? 


a 


Opii 


it 


Cantharidis 


a 


" Catnphorata 


t< 


Capsici 


a 


" Deodorata 


u 


Cardamomi 


a 


Physostigmatis 


(( 


" Composita 


a 


Pyrethri 


(( 


Catechu Composita 


it 


Quassiae 


<< 


Chirata? 


a 


Rhei 


(( 


Cimicifugae 


a 


" Aromatica 


(( 


Cinchona? 


li 


" Dulcis 


(( 


" Composita 


u 


Sanguinaria? 


(( 


Cinnamomi 


a 


Saponis Viridis 


<( 


Colchici 


tt 


Scilla? 


u 


Conii 


it 


Serpentarise 


(( 


Croci 


it 


Stramonii 


l( 


Cubebae ■ 


tt 


Sumbul 


(( 


Digitalis 


tt 


Tolutana 


(( 


Ferri Acetatis 


a 


Valeriana? 


(( 


Ferri Chloridi 


a 


" Ammoniata 


(( 


Galla? 


a 


Vanilla? 


It 


Gelsemii 


a 


Veratri Viridis 


<( 


Gentiana? Composita 


it 


Zingiberis 


<< 


Guaiaci 


Tinctur, 


se Herbarum Recentium.] 


(( 


" Ammoniata 







TRAGACANTHA — TRITICUM. 48? 



TRAGACANTHA—TRAGACANTHA. 

[.4 gummy exudation from Astragalus Gummifer, Labillardi&re, and from 
other species of Astragalus (iV. 0. Leguminosoz, Papilionaceoz) . 

Officinal Preparation, U. S. 

Mueilago Tragacanth.® (Tragacanth 6, glycerin 18, 
water q. s. ad 100), as a vehicle. 

It is the basis of most of the officinal, troches.] 

Tragacanth is of service as a vehicle for the suspension 
and division of various powdered drugs. 



[TRITTCUM—TRITICUM (COUCH-GRASS). 

The rhizome of Triticum repens, Linne (N. 0. Graminaceaz) , gathered 
in the spring and deprived of its rootlets. 

Extractum Tritici Fluidum. Dose, 3j-iv (4 to 16 

Gm.). 

Couch-grass has some domestic reputation in pulmonary 
affections. It has some diuretic properties. It is devoid of 
starch or resinous matter, but contains about twenty-two 
per cent, of sugars. It is an innocent remedy, and may be 
given as a decoction ad libitum or in the form of fluid ex- 
tract, which is a pleasant malt-like preparation.] 



[Trochisci. 

The officinal Lozenges are : — 



Troch 



sci Acidi Tannici Trochisci Krameriae 

Ammonii Chloridi " Magnesia? 

Catechu " Mentha? Piperita? 

Creta? " Morph. et Ipecacuanha? 

Cubebse " Potassii Chloratis 

Ferri " Sodii Bicarbonatis 

Glycyrrhiza? et Opii " Sodii Santoninatis 

Ipecacuanha? " Zingiberis.] 



488 ELM — USTILAGO. 

ULMUS— ELM (SLIPPERY ELM). 

[ The inner bark of Ulmusfulva, Michaux (2V. 0, Urticacece, Ulmece). 

Officinal Preparation, U. S. 

Mueilago Ulmi. Used externally, or as a vehicle.] 

Elm bark is probably tonic and astringent, but is rarely 
if ever used [except as an emollient application in external 
inflammations, such as erysipelas]. 



[Unguenta. 

The officinal Ointments are — 

Unguentum Acidi Carbolici Unguentura Iodi 

" " Gallici " Iodoformi 

" " Tannici " Mezerei 

" Aquse Rosse " Picis Liquidae 

" Belladonnae " Plumbi Carbonatis 

" Chrysarobiui " " Iodidi 

" Diachylon " Potassii Iodidi 

" Gallse " Stramonii 

" Hydrargyri " Sulphuris 

" Amraoniati " " Alkalinum 

" " Nitratis " Veratrinae 

Oxidi Flavi " ZinciOxidi.J 
" " Rubri 



[USTILAGO— USTILAGO (CORN SMUT). • 

Ustilago Maydis, Leveille (N. 0. Fungi), grown upon Zea Mays, Linne 
(N. 0. Graminaceos) . Ustilago should be preserved in a dry place 
and should not be kept longer than a year. 

Ustilago or corn-ergot contains about five and a half per 
cent, of an amorphous substance resembling sclerotic acid; 
it also contains a fixed oil, and a volatile amine-like sub- 
stance soluble in ether, which apparently is identical with 
trimethylamine. It is used as a substitute for ergot in 
stimulating the contractions of the uterus during labor. 
The fluid extract (not officinal) is used in about the same 
doses as ergot (^xv-3j = 1-4 Gin.).] 



UVA URSI — VALERIAN. 489 

UVA URSI— UVA URSI (BEARBERRY). 

[ The leaves of Arctostaphylos Uva Ursi, Sprengel (N. 0. Ericacece). 

Officinal Preparation, U. S. 

Extractum Uvae Ursi Fluidum. Dose, fjss to j 
(2. to 4. Gm.).] 

Uva ursi is astringent and The astringency of this 

possibly diuretic. [It is also drug being principally di- 
tonic and antilithic, and is rected to the genito-urinary 
believed to favor uterine con- mucous membrane, it is held 
traction.] by surgeons to be of some 

service in various chronic 
affections of these parts. 



VALERIANA— VALERIAN. 

[ The rhizome and rootlets of Valeriana officinalis, Linne* (2V. 0. Valeri- 
anaceoz). 

Dose, in substance, gr. xxx to 3jss (2. to 6. Gm.). 

Officinal Preparations, U. S. 

Abstraetum Valerianae. Dose, gr. v-xxx (.30 to 2. 
Gm.). 

Extractum Valerianae Fluidum. Dose, f'3ss to j 
(2. to 4. Gm.). 

Oleum Valerianae. Dose, gtt. ij-v (.13 to .30 Gm.). 

Tinetura Valerianae (20 per cent.). Dose, f'3J-lJ 
(4. to 8. Gm.). 

Tinetura Valerianae Ammoniata (powdered 
valerian 20 parts, with aromatic spirits of ammonia to make 
100 parts). Dose, f5j-ij (4. to 8. Gm.). 

The officinal Valerianates are: — 

Ammonii Valerianas. ] 

Ferri Valerianas. ! Dose, gr. j-ij (.06 to 

Quininae Valerianas. [ .12 Gm.).] 

Zinei Valerianas. 



490 



VANILLA. 



Effects and Uses. 



The more important thera- 
peutic applications of valerian 
have not stood the test of 
time and experience, and its 
use is now practically re- 
stricted to hysteria and the 
various nervous conditions 
depending thereon. [In 
nervous headache, the am- 
moniated tincture is a reliable 
resource.] 



Various elaborate investi- 
gations have been made in 
Germany on the physiologi- 
cal actions of valerian, but 
they have not much bearing 
on its practical application, 
and the drug itself is hardly 
of sufficient importance to 
justify us in devoting much 
time to its consideration. 
We may therefore say, gene- 
rally, that acceleration of the 
action of the heart, mental 
hallucinations, giddiness, and 
some digestive derangement 
are among the principal of 
the symptoms described most 
fully by Phillips. 



[The oil is supposed to be the active principle. It may 
be used with ether for inhalation, in nervous headache. 
The salts of valerianic acid are now generally used in the 
place of the preparations of valerian itself. These salts may 
be given in pill or in combination with simple elixir. The 
elixir of valerianate of ammonia is generally kept in the 
shops.] 



[VANILLA— VANILLA. 

The fruit of Vanilla planifolia, Andrews (N. 0. Orchidaceai) . 

Tinetura Vanillae, the only officinal preparation, is 
used as a flavoring for articles of food for the sick. Vanilla 
also is used as a flavoring ingredient in Trochisci Ferri 
and Trochisci Potassii Chloratis.] 



VERATRINE. 491 



VERATRINA— VERATRINE. 

[An alkaloid or mixture of alkaloids, prepared from the seeds of 
Asagrea officinalis, Lindley (2V. 0. Melanthacete). 

Officinal Preparations, U. S. 

Oleatum Veratrinae (2 per cent.). External use. 
Unguentum Veratrinae (4 per cent.). External use. 

Poisoning. 

In directly fatal doses, veratrine depresses the whole nerv- 
ous system ; the respiration and circulation are gradually 
suspended ; the convulsive movements, noticed under smaller 
doses, now pass into tetanus, the rigidity of the muscles of 
the chest impedes respiration, and death takes place by as- 
phyxia (Dr. Stille). 1 

Antidotes. 

Vegetable astringent infusions, containing tannic acid, 
should be freely administered, the stomach washed out, fol- 
lowed by stimulants and an opium suppository, or enema. 
Tincture of digitalis would seem to be a physiological anti- 
dote. Whisky may be given hypodermically on the ap- 
proach of collapse.] 

External Actions. 
Physiological. Therapeutical. 

The application of vera- Veratrine has been used 

trine to the skin causes first with success as a local appli- 

pricking and tingling, fol- cation in cases of neuralgia 

lowed by redness and acute of the fifth nerve, but its irri- 

darting pain. To this sue- tating properties must always 

ceeds numbness, due, in all be a barrier to its extensive 

probability, to some local employment. [The officinal 

ancesthetic influence on the ointment generally requires 

extremities of the sensory dilution \ to f . When used, 

nerves. care should be taken not to 

The slightest contact of rub the eyes with the greasy 

1 [National Dispensatory, Phila., 1879. p. 1478.] 



492 



VERATRINE. 



veratrine with the nasal mu- fingers, as violent conjunc- 
cous membrane causes vio- tival irritation may result.] 
lent irritation and prolonged 
sneezing. 

Internal Actions. 
Physiological. Therapeutical. 

Brain and Nervous Sys- 
tem. — No action on the 
brain. 

Spinal Cord. — A good 
deal of elaborate, but unfortu- 
nately contradictory, experi- 
mental evidence has been 
adduced by various observers 
with reference to the effects of 
veratrine on voluntary move- 
ment. In the first place 
convulsions and even tetanic 
spasms may be produced by 
the administration of the 
drug, but these are speedily 
followed by paralysis and 
complete muscular prostra- 
tion ; and the balance of testi- 
mony goes to show that this 
is due to a primary excit- 
ing and secondary paralyzing 
action on the muscular struc- 
tures themselves. 

I. Heart and Circulation. 
— Veratrine first increases 
the action of . the heart by 
stimulating its motor ganglia, 
but secondary slowing and 
depression rapidly ensue from 
an exciting action on the vagi. 

Respiration is at first 
quickened, but subsequently 
retarded by the lowering 
effect of the drug on the re- 
spiratory centre. The tem- 
perature of the body falls. 



I. Veratrine is never used 
internally in this country. 
Trousseau advises its use in 
pneumonia, and in gout and 
rheumatism. 



VERATRDM VIRIDE. 



493 



Digestive and Secreting 
Organs. — Veratrine often 
causes troublesome vomiting 
and purging, and the saliva 
and sweat are increased. 



VERATRUM VIRIDE-^VERATRUM VIRIDE 
(AMERICAN HELLEBORE). 

[ The rhizome and rootlets of Veratrum viride, Alton (iV. 0. Melanthacem') . 
Officinal Preparations, U. S. 

Extraetum Veratri Viridis Fluidum. Dose, gtt. 
j-iij (.06 to. 20 Gm.). 

Tinetura Veratri Viridis (50 per cent.). Dose, 
gtt. iij-viij (.20 to .50 Gm.).] 

Some local action has been observed, of an irritant nature, 
somewhat resembling that of veratrine. 



Constitution 
Physiological. 

1. Brain and Nervous 
System. — 1. Green hellebore 
has no action on the brain. 

2. Spinal Cord -A very 

decidedly depressing effect 
is exerted on the spine, indi- 
cated by extreme muscular 
prostration. 

II. Heart and Circulation. 
— Veratrum viride is also a 
powerful vascular depressant, 
the pulse rate being lowered, 
and the arterial tension di- 
minished ; these effects being 
due both to a direct action of 
the drug on the heart muscle 
and tostimulation of the car- 
diac inhibitory nerves. 



42 



al Actions. 

Therapeutical. 



2. [It has been given in 
large doses in puerperal 
eclampsia.^ 



II. Veratrum viride has 
been extensively used in 
America on account of its 
depressing influence on the 
circulation, and it is stated 
that we may get good results 
by prescribing it in the early 
stages of pneumonia and 
other inflammatory condi- 
tions. Little or no English 
experience, however, has yet 
been brought to bear on the 
discussion of this question. 



494 



VIBURNUM. 



[It was formerly used in 
typhoid fever as an antipy- 
retic. It only acts as an anti- 
phlogistic when physiological 
symptoms are decidedly de- 
veloped.] 

III. No effect is produced 
on the respiration, but a dis- ' 
tinct lowering of temperature 
has been observed. 

IV. Digestive and Secret- 
ing Organs Veratrum vi- 

ride has emetic properties, 
and frequently causes vomit- 
ing ; and purging, also, not 
unfrequently follows its use. 

Two alkaloids exist in veratrum viride, Jervinb and 
Veratroidine, the main difference between which seems 
to be, that the latter is apparently responsible for the diges- 
tive disturbance which occasionally results. 



[IV. The nauseating 
depressing effects are 
counteracted by opium 
alcoholic stimulants.] 



and 
best 
and 



[VIBURNUM— VIBURNUM (BLACK HAW). 

The bark of Viburnum prunifolium, Linne (N. 0. Caprifoliacece) . 

Extractum Viburni Fluidum. Dose, 3 ss -j ( 2 - 
to 4. Gm.). 

Black-haw bark contains valerianic acid, resin, tannic 
acid and a bitter principle. It has some reputation for pre- 
venting threatened abortion, especially where there is a 
known tendency to this accident. It is also given for dys- 
menorrhea. The fluid extract is a good preparation. Dose, 
5j-ij (4. to 8. Gm.).] 



[Vina. 

The officinal Wines are — 



Vinuni Album Fortius 

" Aloes 

" Antirnonii 

" Aromaticum 

" Colchici Radicis 
" " Seminis 

" Ergotae 



Vinum Ferri Amarum 
" " Citratis" 

" Ipecacuanhae 
" Opii 
" Rhei 
" Rubrum.] 



VIOLA TRICOLOR — XANTHOXYLUM. 495 

[VIOLA TRICOLOR— VIOLA TRICOLOR 

(PANSY). 

The wild- grown flowering herb of Viola tricolor, Linni (N. 0. Violaceue). 

The syrup of viola is an agreeably fragrant syrup, but is 
not officinal. The crude drug is supposed to contain the 
emetic and cathartic principle, violin, found in viola odorata, 
and to possess some alterative virtues. It has been recom- 
mended in eczema, but is not of much therapeutic interest.] 



[VITELLUS— YOLK OF EGG. 

The yolk of the egg of Gallus Bankiva, var. Domesticus, Temminck 
( Class Aves, Order Gallinos) . 

Officinal Preparations, U. S. 

Glyceritum Vitelli (Fresh yolk of egg 45, glycerin 
55 parts). For external use. 

Mistura Chloroformi (Purified chloroform 8, cam- 
phor 2, fresh yolk of egg 10, water 80 parts). Dose, $j-'\v 
(4. to 16. Gm.). 

The yolk of egg possesses high food value, as it consists 
principally of yellow oil; it also contains lecithin, which is 
a phosphorized fatty substance. It is a valuable addition to 
the diet of convalescents or consumptives.] 



[XANTHOXYLUM _ XANTHOXYLUM (PRICKLY 
ASH). 

The bark of Xanthoxylum fraxineum, Willdenoiv, and of Xanthoxylum 
carolinianu?n, Lambert (N. 0. Rutaceoz, Xanthoxyleaz). 

Extractum Xanthoxyli Fluidum. Dose, 5 ss -j 
(2 to 4 Gm.). 

Prickly-ash bark contains a bitter principle, probably an 
alkaloid, tannic acid, resin, oil, etc. The fluid extract is a 
strong tincture, and is given in doses of 8 to 30 minims (.5 
to 2. Gm.) in flatulent colic, suppression of menses, chronic 
rheumatism, syphilis, liver disorders, etc.] 



496 zinc. 

ZINCUM—ZINC. 

[Metallic zinc, in the form of sheets or irregular granulated pieces. 

Officinal Preparations. 

Zinei Oxidum. Dose, gr. ij-x (.12 to .65 Gm.). 

Unguentum Zinci Oxidi (20 per cent.). External use. 
Zinei Bromidum. Dose, gr. j-ij (.06 to .13 Gm.). 
Zinei Chloridum. As a caustic and astringent. 
Liquor Zinci Chloridi (50 percent.). (Burnett's Disin- 
fecting Fluid.) 
Zinei Aeetas. Dose, gr. |-ij (.03 to .13 Gm.). 
Zinei Carbonas Prffieipitatus. For external use. 
Zinei Iodidum. Dose, gr. -J-ij (.05 to .13 Gm.). 
Zinei Phosphidum. Dose, gr. 2V -to (- 003 t0 - 006 
Gm.). 

Zinci Sulphas (white vitriol). Dose, as an emetic, 
gr. x-xxx (.65 to 2. Gm.). 

Zinei Valerianas. Dose, gr. i-ij (.06 to .12 Gm.). 

Antidotes. 

The alkalies and alkaline carbonates are the chemical 
antidotes to the salts of zinc. Evacuation of the stomach 
and bowels should be followed by the exhibition of eggs and 
milk. The retching, colicky pains, and diarrhoea may be 
relieved by morphine hypodermically.] 

Local Actions. 

Physiological. Therapeutical. 

Chloride of zinc is an ex- Chloride of zinc has been 

ceedingly powerful caustic, used as a caustic for the 

and, in weak solution, has treatment of cancerous and 

astringent properties. The other ulcerations, either in 

sulphate and oxide are also strong solution, substance, 

astringent in varying propor- or arrow-shaped masses made 

tions. [Owing to its power with flour, and inserted into 

of preventing the development incisions around the base of 

of micro-organisms it has a the morbid mass. It has 

place in the antiseptic treat- turned out to be the principal 

ment of wounds ; and is ingredient in all so-called 



zinc. 497 

largely used in preserving cancer-curer's nostrums, and 
cadavers for dissection.] is employed in legitimate 

surgery as an application to 
wounds from which cancerous 
growths have been removed, 
and also (in the strength of 
gr. lx and f§j) to the raw 
surface after ordinary opera- 
tions, w T ith the view of pre- 
venting pyaemia. 

Sulphate of zinc is a much- 
valued astringent lotion in 
conjunctivitis, and makes an 
excellent injection in gonor- 
rhoea, conjunctivitis, and leu- 
corrhoea; and the oxide, 
either in powder or ointment, 
is one of the most useful ap- 
plications in chronic skin 
disease. The oleate of zinc 
forms an excellent application 
in acute eczema. [The acetate 
is used for the same purpose 
as the sulphate (gr. ^ to ^ in 
rose-water ^j).] 

Internal Actions and Uses. 

Physiological. Therapeutical. 

1. Action on Nervous Sys- 1. We can thus explain 

tern This is probably tonic the benefit which sometimes 

in character, and some as- results from the use of sul- 
tringent properties may also phate of zinc in chorea. 
be noted. We here begin with a grain 

and continue in gradually 
increasing doses up to 6 or 
8 grains, tolerance being 
rapidly established, and the 
emetic action of the drug 
avoided. Oxide of zinc, in 
doses of from 1 to 5 grains, 
is an excellent remedy in the 
night-siveats of phthisis, and 
42* 



498 • GINGER. 

it is also a valuable aid to 

treatment in the diarrhoea of 

children. 

2. On Digestive System. 2. It is therefore our most 

— Sulphate of zinc promptly reliable direct emetic, inva- 

and effectually empties the luable in cases of poisoning, 

stomach, without causing in doses of from 20 to 30 

much depression or nausea, grains. 

f£. Zinci sulphatis gr. xxx ; or 21 Gm. 

Aquae f |viij ; " 256j " M. 

Fiat haustus emeticus statim sumendus. 

I£. Zinci cliloridi gr. j ; or |06 Gm. 

Aquae rosse f giv ; " 128 1 " M. 



A good injection in gonorrhoea. 

R. Zinci oxidi 3ij ; or 8 

Glycerini f 5ij ; " 8 

Liquor plumbi subacetatis f3 is s; " 6 

Aquae calcis q. s. ad f^vj ; " 152 

Fiat lotio. 



Gm. 
" M. 



Useful in impetigo. 

I£. Zinci valerianatis gr. xxiv ; or 150| Gm. 

Confectionis rosae q. s. I 

Fiat massa in pilulas duodecim dividenda. Deaurentur 
pilulae. 

Nervine tonic. 

The permanganate and the sulphocarbolate of zinc make 
good injections in gonorrhoea. [Dr. Waugh uses the sul- 
phocarbolate in 2-3 grain doses in cases of typhoid fever to 
control diarrhoea.] 



ZINGIBER— GINGER. 

[ The rhizome of Zingiber officinale, Roscoe (N. 0. Zingiberacece). 
Dose, in substance, gr. x-xv (.65 to 1. Gm.). 

Officinal Preparations, U. S. 

Extraetum Zingiberis Fluidum. Dose, ni^x-xx 
(.65 to 1.30 Gm.). 

Oleo-resina Zingiberis. Dose, ni^ss-ij (.03 to .12 
Gm.). 



GINGER. 499 

Syrupus Zingiberis. Dose, 3j-ij (4. to 8. Gm.). 

Tinctura Zingiberis (20 per cent.). Dose, ir^x-lx 
(.65 to 4. Gm.). 

Troehisei Zingiberis (each containing two grains 
of the tincture). Dose, 1 to 5. 

Also enters into Acidum Sulphuricum Aromaticum, 
Pulvis Aromaticus, Pulvis Rhei Compositus, and Vinum 
Aloes.] 

Ginger is an agreeable stimulant and carminative. 



NON-OFFICINAL PREPARATIONS. 



Having now completed the study of the various articles 
contained in the National Pharmacopoeia, we shall proceed to 
give a brief resume of the properties of the most useful among 
those drugs which have not yet received official sanction. 
Among these will be found some very important remedies, in 
addition to plants of great physiological interest, whose active 
medicinal powers have not yet been fully tested in practical 
medicine, and whose investigation opens up a valuable field 
for clinical observation. 

Antipyrin has undoubted antipyretic properties, and has 
proved useful in the fever of phthisis in doses of 15 grains 
twice a day. We must prescribe it, however, with a certain 
amount of caution, as serious and even fatal collapse has 
followed its use, and as vomiting and a measly eruption are 
occasionally sequelae. [It has proved useful in spasmodic 
affections in whooping-cough and asthma, in doses of 3 to 5 
grains. It has a decided influence over sensory nerves, and 
controls neuralgia and migraine in a remarkable manner. 
In some cases sea sickness has been relieved by it.] 

Casca Bark is the bark of erythrophloeum guineense, 
generally called casca, cassa, or sassy bark. 1 This is the 
ordeal bark of Angola. If the victim vomits he is acquitted, 
if it causes purging he is put to death. In an examination 
into its physiological action by Brunton and Walter Pye, fifty- 
four experiments were tried on various animals, and it was 
found to uniformly cause vomiting, purging, weakness, and 
finally death during a convulsion. 

The purgation is probably due to a local action, as it never 
follows subcutaneous injection. The intestinal secretion is 

1 See Phil. Trans. Royal Soc, vol. cvii. part 2, rev. ed., 1870. 



NON-OFFICINAL PREPARATIONS. 501 

not increased ; respiration is accelerated from stimulation of 
pulmonary branches of vagus, and not from action on respi- 
ratory centre. On circulation a primary slowing is caused 
from stimulation of the vagi, as it ceases after section of 
these nerves ; and secondarily quickening, by paralysis of 
the ends of the vagus in the heart, thus resembling the action 
of digitalis. The arterioles contract (either directly or) 
from nervous action, the blood-pressure rises, and secretion 
of urine is increased. Brunton believes that it will be found 
even a more effectual drug than digitalis. 
Powdered casca is a sternutatory. 

Convallaria Majalis has been found to be a cardiac 
tonic and diuretic, acting usefully in failure of compensation 
in mitral stenosis and regurgitation. Dose, gr. v of the ex- 
tract. 

Curare or Woorara is the South American arrow-poison. 
Dose, gr. T L (.006 Gm.). This is a watery extract of several 
plants, prominent among which are two belonging to the spe- 
cies of strychnos and cocculus (probably Strychnos Castelnce, 
Wed., and Cocculus toxiferus, Wed.), and a variety of pepper. 
It has the consistence of thick paste, becoming brittle on dry- 
ing ; is blackish-brown in color, and has a bitter taste. [It is 
probable that its composition varies in different localities.] 

Physiological. Therapeutical. 

Curare is an irritant to It is only applied to 
denuded surfaces, causing pain wounds for its constitutional 
and inflammation. influence. 

Constitutional Effects. 

1. Nervous System. — The 1. In epilepsy and chorea, 

mind remains clear. The in- curare has been tried and 
ferior extremities are first and found to be useless, 
chiefly affected. " It seems 
probable, however, that the 
primary operation of woorara 
is upon the terminations of 
the nerves, and not on their 
central origin" (Stille). 



502 



NON-OFFICINAL PREPARATIONS 



2. Muscular System. — 
When injected into the blood, 
or hypodermically, curare 
causes general muscular paral- 
ysis, first affecting the in- 
ferior extremities, but ulti- 
mately involving all the 
muscles, including those of 
respiration. A large dose 
causes death by paralysis of 
respiration and asphyxia, but 
the heart continues beating 
after the breathing ceases, 
and animals may be restored 
by artificial respiration. 

It is apt to cause ptosis in 
man, and mydriasis and diplo- 
pia may occur. 



2. This agent has been 
employed in almost all forms 
of muscular spasm, but it is in 
tetanus that it has achieved its 
best results. It is certain 
that it reduces the muscular 
contractions and saves the 
patient from the consequent 
exhaustion. It is reported to 
have cured 13 out of 33 cases 
of tetanus, and deserves fur- 
ther trial. 

In hydrophobia it also ex- 
erts a good effect by relieving 
the violence of the convulsions 
and reducing their frequency. 
In three cases it has been 
thought to have cured patients 
afflicted with rabies canina. 

3. As it is believed that if 
any abrasion or ulcer exist in 
the stomach the drug may 
exhibit its toxic effects, its 
internal use is not considered 
advisable in any considerable 
dose. 



3. Upon Secretion. — When 
taken by the mouth, curare 
is eliminated by the secretions 
nearly as rapidly as absorbed, 
so that it is almost'innocuous 
in this way, simply acting as 
a diuretic and diaphoretic. 

Curare is best exhibited hypodermically, in order to insure 
exactness of administration. A solution in distilled water (one 
part in one hundred) is the most available form, but it should 
be freshly prepared. Ten minims of this solution would be 
the ordinary dose, to be carefully repeated until its charac- 
teristic effects on the muscular system are observed. 

What has been termed the sulphate of curarine has been 
used in doses of one-tenth that of the extract. 



Dichloride of Ethidene has lately been introduced as 
an anaesthetic, and has been favorably reported on by the 
Glasgow committee of the British Medical Association. 

It seems to be intermediate in its effects between chloro- 
form and ether, depressing the heart and causing sickness in 
a less degree (and less capriciously) than the former vapor. 
Clover values it in minor cases, using it after the previous 
production of insensibility by nitrous oxide gas. 



NON-OFFICINAL PREPARATIONS. 503 

Duboisia. [The leaves of Duboisia Myoporoides.] — 
The actions of this drug strongly resemble those of atro- 
pine, as it causes throat dryness, dilatation of the pupil, cepha- 
lalgia, vertigo, and drowsiness, the pulse and respiration being 
quickened, and a reddish eruption sometimes appearing on 
the skin. It has been successfully given in the sweating of 
phthisis. [Dose of the extract gr. j? to ^ ; of Duboisine Sul- 
phas, gr. T J^ to ^L-. It is also used as a mydriatic by ocu- 
lists, its effects being more transitory than atropine.] 

Ethyl Bromide has been used as an anaesthetic, two 
drachms being sufficient to cause insensibility. It acts 
quickly, the effect rapidly passes off, and it does not physio- 
logically depress the heart or breathing, but several deaths have 
followed its administration, and its use, therefore, has been 
discontinued. [Where the chemically pure drug is used it 
has been found to answer the purpose of an anaesthetic, being 
safer than chloroform and more pleasant than ether.] 

Ethtlate of Sodium. . This is enthusiastically praised 
by Richardson as an application to naevus, mother's marks, 
lupus, and nasal polypi. It should be painted on with a 
camel-hair brush, and the resulting pain, which is often se- 
vere, may be relieved by an alcoholic solution of opium. 

Fuchsine in dose of gr. j in pill, diminishes the albumen 
in the urine, in chronic kidney disease. 

Grindelia Robusta in the form of fluid extract has been 
highly praised as a remedy for asthma. The dose is 3vj °f tne 
fluid extract every quarter of an hour during the attack, fol- 
lowed by smaller doses during the interval. 

Jeqcirity in fresh infusion has been a good deal used of 
late as an application to granular lids. It often causes, how- 
ever, a good deal of irritation, which may become unman- 
ageable and destructive ; and we would counsel caution in its 
employment. 

Muscarin (Agaricus Muscaria) causes perspiration, 
flushing, giddiness, and salivation, but in a less degree than 
jaborandi, and acts more on the bowels. 

It slows the heart and causes dyspnoea from contraction 



504 NON-OFFICINAL PREPARATIONS. 

of the pulmonary vessels. "When given by the stomach it 
contracts, but when topically applied widely dilates, the pupil. 
It is at present, however, only a physiological curiosity, and is 
never used in medicine, its principal interest being the very 
exact antagonism to atropine which it possesses. 

[Murell recommends it in the sweating of phthisis, in 
dose of five minims of a one per cent, solution of the watery 
extract.] 

Nitrite of Sodium has been recommended in cases of 
epilepsy and angina pectoris, and appears to have been occa- 
sionally of service. But it possesses very active physiologi- 
cal properties, and is apt to cause a variety of nervous symp- 
toms, which are both uncomfortable and alarming, and 
which more than neutralize any advantages to be derived 
from its use. 

Osmic Acid seems to have some locally soothing effect in 
cases of neuralgia and sciatica, from 3 to 5 minims of a one 
per cent, aqueous solution being injected deeply into the 
neighborhood of the affected nerve. 

Paraldehyde [a modification of aldehyde, a clear, pun- 
gent liquid] is a good hypnotic, acting quickly, safely, and 
well, causing no headache nor digestive disturbance, and 
exerting no depressing action on the heart. It is thus ser- 
viceable in cases where chloral is inadmissible. Dose, i'^ss- 
ij (4 to 8 Gm.), with syrup and a bitter tincture. 

[Petroselinum — Parsley, is the root of Petroselinum 
sativum. The neutral liquid active principle, Apiol, has 
attained some reputation in the treatment of inter mittents, 
and is also used in neuralgia and dysmenorrhea. Its nau- 
seating taste requires it to be given in capsule (gr. 3 T 9 ^). 
Dose, one to four.] 

[Quebracho — Quebracho Bark is the bark of the tree 
Aspidosperma Quebracho (Schlechtendahl). A member of 
the family of Apocyneae, the aspidosperma quebracho is a 
native of the northern part of South America, and is obtained 
from the province Catamarea, 1 of the Argentine Republic, 
where it has long been popular as a febrifuge. 

1 Primke, Pharm., Zeitung, No. 9, 1880. 



NON-OFFICINAL PREPARATIONS. 



505 



In 1878, Schickendanz sent some of this bark to Europe, 
as a succedaneum for cinchona bark, where Dr. Penzoldt, 1 
after testing its therapeutic effects, pronounced it a remedy 
of considerable power, and Fraude 2 isolated from it an alka- 
loid " aspidospermine," which is insoluble in glycerine, but 
dissolves in fats and oils ; and produces the same physiologi- 
cal effects as the bark itself. Dose, as an antiperiodic, gr. 
xviij. (Guttman.) 

The following pharmaceutical preparations have been 
made : — 

Tinctura Quebracho (macerate in 5 parts alcohol, 50 per 
cent, for 8 days and filter). 

Tinctura Quebracho Composita (bark 2, orange peel 1 
part, alcohol 5 parts). 

Vinum Quebracho (bark 1, 56 per cent, alcohol 2 parts, 
white wine 16 parts). 

Elixir Quebracho. 

Extractum Quebracho Fluidum. Dose, n^xx-lx (1.30 to 
4. Gm.). 



Physiological Effects. 

Digestive Tract. — Taste 
bitter, astringent, and per- 
sistent or nauseating. Sali- 
vation has appeared both in 
dogs and man. Has some 
astringent effects upon the 
alimentary tract. When 

used for any length of time, 
disagreeable effects are often 
produced which forbid its 
continuance. 

Nervous System Motor 

paralysis of the limbs of 
central origin (Penzoldt). 
Paralysis of respiration, di- 
minished frequency of heart's 
action (not due to inhibition). 
Death caused by general 



Therapeutical Effects. 

The tincture has been 
recommended for diarrhoza 
in phthisis; and in chronic 
diarrhoea in children. 



In moderate doses may 
relieve restlessness of fevers, 
but has special value where 
the respirations are increased 
greatly above the normal. 
In attacks of rapid breathing 
during consumption, and in 



1 Gr. Fraude, Berichte der Deutschen Chem. Gesellschaft, 1875 

2 F. Penzoldt, Berlin Klinische-Woehenschrift, No. 19, 1879. 

43 



506 NON-OFFICINAL PREPARATIONS. 

paralysis, dyspnoea, and con- cases of palpitation accom- 

vulsions (from apnoea?). panying cardiac hypertrophy 

quebracho has given marked 
relief. 

Respiration. — Breathing It is used with great bene- 

deepened and retarded by fit in emphysema, bronchial 

moderate doses. catarrh, periodic asthma, etc. 

Special Action. — Princi- In asthma dependent upon 

pally upon motor apparatus valvular insufficiency it is 

of respiration. No percep- less valuable than in spas- 

tible influence upon tempera- modic asthma where it ex- 

ture, nor upon malarial mani- erts a special action.] 
festations. 



[Resorcin (C 7 H 8 2 ) is formed by fusing certain gums 
(galbanum, asafoetida, ammoniac, etc.) with potassium 
hydrate, the resulting mass dissolved in water super-saturated 
with sulphuric acid, subsequently filtering and agitating the 
filtered solution with ether which dissolves out the resorcin, 
and from which it is subsequently obtained by evaporating, 
and distilling ; the resorcin sublimes and condenses in radiated 
crystals. (Wurtz.) The crystals are colorless and very so- 
luble in water, alcohol, and ether. 

Resorcin is very destructive to infusoria and the low 
forms of organisms of fermentation and putrefaction ; it is 
more active even than carbolic acid. It may be applied 
locally to parasitic skin diseases, or suppurating wounds, 
without producing irritation. 

Taken internally, in doses of gr. x-5j (.65 to 4. Gm.), 
it accelerates the pulse, stimulates the secretions, increasing 
the flow of the saliva and the activity of the sudoriparous 
glands ; and secondarily depresses the temperature and the 
circulation. As an antipyretic the dose is from gr. xx to 
3j (1.33 to 4. Gm.), and in this dose it has been used in 
hyperpyrexia to meet the same indications as maximum 
doses of quinine, for which it may be substituted. It may 
also be administered hypodermically.] 

Terebene [prepared by action of sulphuric acid on oil of 
turpentine] is a good antiseptic and germicide [and expec- 
torant. Dose, n^v-xv (.30 to 1. Gm.).] 



LEECHES. 501 

TRIMEtfHYL AMINE AND ITS HYDROCHLORATE. [Trime- 

thylaminis hydrochloras. Dose, gr. iij-x (.20 to .65 Gra.). 
Propylamine is an impure trimethylamine.] 
Lowering of temperature and pulse is said to follow the 
use of this drug, and it has been much recommended as a 
remedy for acute rheumatism. [Trimethylamine is irrita- 
ting to the stomach, and should be given well diluted; pep- 
permint water is the usual vehicle. On account of its de- 
pressing effect upon the heart and lungs, it may lead to fatal 
narcosis from retention of carbonic acid in the blood. The 
proper treatment of poisoning would be by opium and bella- 
donna (morphine and atropine), and stimulants. Ammonia 
should not be used.] 

Vaseline is a soothing and agreeable application in skin 
diseases. [Now officinal as Petrolatum, p. 404.] 

Kaposi strongly recommends in eczema an ointment made 
by dissolving and thoroughly incorporating by heat equal 
parts of lead plaster and vaseline, adding a little oil of 
bergamot. 



LEECHES. 

[Hirudo. Sanguisuga Officinalis.} 

Leeches are undoubtedly the most convenient means for 
the local abstraction of blood, and are used to relieve pain, 
which they do very effectually in certain local inflammations, 
as pleurisy, pericarditis, orchitis, iritis, hepatitis, perito- 
nitis ; and there is reason to believe that, when applied 
sufficiently early, they may even moderate the inflammatory 
process. Their action, no doubt, may frequently be ex- 
plained by direct vascular communication between superficial 
vessels and those of deeper parts. 

Each leech may contain about 1^ dr. of blood, and subse- 
quent fomentation may draw so much more from the skin as 
to raise the total amount up to half an ounce. Should the 
subsequent bleeding prove difficult of arrest, as sometimes 
happens, we may succeed in staunching the flow by means 
of pressure, cold, various astringents, the application of solid 
nitrate of silver, or the twisted suture. [The American 
only takes about one-third as much blood as the imported 



50S QUESTIONS. 

leech, and, on this account, is preferred by some in the treat- 
ment of diseases of children.] 

Special cautions in the use of leeches are — never to apply 
them, if possible, to any part over which firm pressure can- 
not subsequently be made, as the larynx ; not to apply them 
in the evening, when, for some unexplained reason, the 
bleeding is more apt to be troublesome ; and, of course, 
never to allow their use in any victim of the hemorrhagic 
diathesis. 

If leeches will not bite, we must smear the skin with 
cream or freshly-drawn blood, or immerse the animal itself 
in porter, which seems to have a stimulating effect ; and 
should one be accidentally swallowed we can kill it, and 
cause its expulsion from the stomach, by common salt. 



QUESTIONS. 

In submitting a series of questions to the consideration of 
the student, I have endeavored to place various suggestive 
points before him in interrogative form, and to approach the 
border line between practical medicine and therapeutics by 
introducing a few short illustrative cases. The principle 
seems to me worthy of further development, and a systematic 
collection of typical cases, with variations and exceptions 
and bedside gleanings, might lead the way profitably up to 
those diffuse collections of symptoms which are occasionally 
rolled into concrete form by our examining boards. 

It would not be difficult to expand my collection of queries 
to an almost unlimited extent ; but the conscientious attempt 
to answer those already constructed will at all events en- 
courage the young reader to think for himself, and to emanci- 
pate his mind and memory from the enervating trammels of 
the more grinding forms of manuals. 



1. A child is under treatment for whooping-cough, and 
the mother states that after each dose of his medicine his face 
flushes and he complains of his throat being very dry. What 
drug is most likely to produce these symptoms? 

2. Mention the different remedies to be employed in the 
various stages of syphilis. 

3. A case of acute eczema presents itself for treatment ; 



QUESTIONS. 509 

there is much moist exudation, with smarting and tingling 
and almost erysipelatous redness. It is proposed to give 
arsenic. Would this meet with your approval, and what 
would be your line of practice ? 

4. A patient comes to you in great alarm, thinking that 
he is paralyzed, his legs feeling weak and heavy, and his gait 
becoming staggering. At the same time you observe a few 
pimples of acne on his forehead, and you learn that he 
has lately been suffering from sleeplessness. To what would 
your suspicions point as the cause of his symptoms? 

5. Give directions for disinfecting a room which has been 
occupied by scarlatinous patients. 

6. Mention a drug which seems to have a specific influence 
over the poison of erysipelas, and write a prescription, with 
full directions for its use. 

7. Write a prescription for an effervescing draught con- 
taining carbonate of ammonium. 

8. Point out the error in the following prescription: — 

R. Tinct. hyoscyami 3«s; liq. potassa3 ir^xx; mucilaginis 
3j ; gentianse infusi ^j. Ter die. 

9. You are called to a very severe case of delirium tremens. 
It seems advisable to give opium, and chloral has already 
failed. What course, therefore, would you pursue? 

10. Mention the antidotes for prussic acid, strychnine, 
arsenic, and opium, with the general line of treatment to be 
pursued in a case of poisoning by each of these substances. 

11. You are called to the following case. A middle-aged 
man has been known to suffer from heart disease, and on 
applying your ear to his chest you hear a well-marked mitral 
regurgitant bruit. His face is pale, with a tendency to livi- 
dity, his feet are beginning to swell, his pulse is weak and 
irregular, and does not accurately correspond to the beat of 
the heart, many of whose pulsations are not transmitted to 
the wrist. There are great anxiety and breathlessness, and 
ordinary stimulants have given only temporary relief. State 
your line of practice in such a case, and more especially the 
drug from which you would expect to derive speedy benefit. 

12. Mention the various drugs which have been of service 
in tetanus, with your opinion of their relative efficiency, and 
give the dose of each. 

13. Explain the action of the principal ansesthetic agents, 
and state what you consider to be most worthy of confidence. 

14. Mention the remedies which act on the pupil, and 

43* 



510 QUESTIONS. 

divide them into those which act locally and constitutionally. 
Are there any drugs which act differently on the pupil when 
taken internally and locally applied? 

15. What is the disadvantage of the following prescrip- 
tion ? 

R. Tincturae opii ttlx; acidi sulphurici diluti ttt^xx; de- 
cocti haematoxyli 3j. Ter die sumend. 

1 6. Write a soothing cough medicine for a case of phthisis, 
and include chlorate of potassium *nd morphine. Dose, one 
teaspoonful. 

17. State the general treatment of a case of chorea, with 
the principal drugs which have been found useful, and give 
your opinion of their respective merits. 

18. What are the indications by which we know that 
conium, arsenic and strychnine are beginning to produce 
their physiological effects? 

19. Mention those drugs which are most readily absorbed 
through the unbroken cuticle. 

20. Enumerate the principal cholagogue cathartics. 

21. State the principal differences between the action of 
opium and morphine. 

22. You are called to see a case of severe sprained ankle, 
and hear that a friend is about to apply tincture of arnica. 
On inquiry you find that this remedy has never been used to 
this patient before. Would you sanction the treatment? 

23. Enumerate those drugs which stimulate, and those 
which depress, the action of the heart. 

24. State which drugs are most worthy of confidence in 
cases of neuralgia of the fifth nerve. 

25. A patient presents himself with the following symp- 
toms : Constipation and violent colicky pain in the belly, 
some loss of power in the extensor muscles of the arms, a 
bluish line along the margin of. the gums, anaemia. What is 
the cause of, and the proper treatment for, his complaint; 
and what prophylactic means would you recommend him to 
adopt ? 

26. Mention the various means of lowering the bodily tem- 
perature in health and disease, and explain their action, more 
especially enumerating those remedies which act only in con- 
ditions of pyrexia. 

27. You have been attending a case of rheumatic fever, 
and all has gone well until you are told one morning that 
the patient has had a disturbed night, has been restless and 



QUESTIONS. 511 

delirious, but that, at the same time, the pain in the joints 
has subsided. You find him looking dull, confused, and only 
partially conscious. The temperature registers 105°, and 
in another hour has gone up to 106°. What treatment 
would you advise ? 

28. State the principal dangers to be anticipated in chloro- 
form administration, with their appropriate remedies. 

29. Mention the unpleasant effects which sometimes follow 
the use of quinine. 

30. What do you mean by " accumulation" in thera- 
peutics ? 

31. A young married woman comes to ask relief for 
troublesome sickness and vomiting, recurring at intervals 
throughout the day, but always worse on first rising in the 
morning. What would you advise in the way of treatment, 
and how can you explain her symptoms? 

32. Write a prescription for an alkaline lotion in a case 
of acute eczema. 

33. Mention the best narcotics to be used under the fol- 
lowing circumstances : — 

1. Sleeplessness from overwork or worry. 

2. Delirium tremens. 

3. The fierce delirium of typhus. 

4. Acute mania. 

34. Write a prescription for iron in combination with 
potassium iodide and a vegetable bitter. 

35. Mention the various drugs which produce eruptions 
on the skin, and describe the forms of eruption produced. 

3-6. Mention the drugs which impart a peculiar color to 
the urine, with the varieties of tint produced. 

37. Contrast the paralyzing effects of conium, Calabar 
bean, and veratrine. 

38. State the physiological phenomena which may follow 
comparatively small doses of quinine, potassium iodide, potas- 
sium bromide, chloral, and mercury. 

39. State what you mean by a "refrigerant." 

40. You are called to see a patient in an advanced stage 
of phthisis, in whom the night sweats are causing serious 
exhaustion. All astringent remedies having failed, what 
drug would you recommend to be employed, and in what 
doses? 

41. A patient is seized with acute tonsillitis, and it is of 
great importance that he should recover his voice in a short 



512 



QUESTIONS. 



time. Mention a drug which you might prescribe with good 
hopes of speedy benefit. 

42. An elderly man is attacked with acute bronchitis, the 
cough and dyspnoea being urgent, and the sputa brought up 
with difficulty. The blood is beginning to be imperfectly 
aerated, the skin looking dusky and the lips blue, and 
although he is occasionally drowsy by day, he can obtain no 
sleep in the night from the constant and irritating cough. 
His family are much distressed at this insomnia, and having 
persuaded the doctor to give him something to make him 
sleep, a full dose of opium is ordered. State the probable 
result of this line of practice. 

43. You are summoned to see a case of ague. The patient 
cannot take bark or quinine in any form. What drug would 
you recommend in their place ? 

44. A case of diarrhoea presents itself, characterized by 
furred tongue, cramping pains in the abdomen, sickness, and 
tenesmus, with the expulsion of rather scanty but thin and 
frequent evacuation. It is proposed to arrest this by means 
of astringents. State whether this treatment would meet 
with your approval, and what your own plan would be. 

45. You are called to a bad case of haemoptysis. All the 
usual astringents and styptics have failed. What drug would 
you recommend, and how would you administer it? 

46. State the best remedies for noctural incontinence 
of urine. 



. 



APPENDIX. 

(ADDED BY THE AMERICAN EDITOR.) 



POISONS. 



A poison is a substance of animal, vegetable, or mineral 
nature, which, when administered in small quantity, is capa- 
ble of producing deleterious effects upon the human system. 
It may be introduced into the economy in a gaseous, liquid, 
or solid form, through any of the channels of absorption, though 
more commonly by the gastro-intestinal tract. 

General Antidote for Poisoning when the Nature 
of Poison is Unknown. 

R. Magnesiae, 

Pulv. carbo. ligni, 

Ferri oxidi rubri, aa gj. M. 

To be given freely in a sufficient quantity of water. 

Or, as suggested by Jeannel : — 

Calcined magnesia . . §ij. 
Washed animal charcoal . §j. 
Water .... fxx. 

To be kept well covered ; when exhibited to be mixed 
with — 

Solution of ferrous sulphate (sp. g-r. 1.45) ^ijss, and well agi- 
tated. 

Given in doses of §jss-iij in poisoning by arsenic, zinc, the alka- 
loids, etc. 1 

This preparation is harmless, but is effective, for its ingre- 
dients are antidotes to the most common and active poisons. 
With it may be given demulcent drinks, such as milk or flour 
and water, to dilute the poison and protect the stomach. 

1 The Practitioner's Reference Book, R. J. Dunglison, Phila., 
1877, p. 228. 



514 TREATMENT OF POISONING. 

Prompt Treatment Table of Poisons. 
Arranged alphabetically for ready reference. 

Acetic Acid. — The alkaline carbonates, chalk, or magnesia. Vom- 
iting should be encouraged, and demulcent drinks freely given. 

Aconite. — Active emetics, or stomach-pump. Stimulation exter- 
nally and internally. Digitalis is a physiological antidote ; also 
finely powdered animal charcoal, or tannin, and astringent infu- 
sions. Ammonia inhalations. 

Alcohol. — Stomach-pump ; cold affusion ; inhalation of vapor or 
hypodermic injection of ammonia ; use of electricity ; digitalis. 

Alum, and Sulphate of Aluminium and Potassium. — Warm dilute 
drinks to produce emesis ; hydrate of magnesia, or weak solution 
of carbonate of ammonia ; stomach-pump. 

Ammonia. — Vegetable acids, as dilute vinegar or lemon-juice ; 
olive oil ; milk given copiously ; stomach-pump should not be 
used. 

Amylene. — Same treatment as for chloroform poisoning. 

Antimony and its Salts. — Tannin, as in tincture or infusion of cin- 
chona, infusion of black tea, or of galls. Free vomiting with 
warm mucilaginous drinks, or stomach-pump. Opium and in- 
ternal and external stimulation may be employed subsequently. 

Aeseniods Acid. — Hydrated sesquioxide of iron to be given in a 
moist state in tablespoonful doses, followed by castor oil. (The 
hydrate may be extemporaneously prepared by adding aqua am- 
monias to dilute tinctura ferri chloridi.) Solution of dialyzed iron 
and freshly precipitated hydrate of magnesia have also been em- 
ployed. These are not reliable if the arsenic has been taken in 
form of powder. In the absence of vomiting, prompt emesis by 
sulphate of zinc or warm mustard and water. Warm demul- 
cent drinks. Also ferrum oxidum hydratum cum magnesia. 

Barium, Salts of. — Sodium or magnesium sulphate ; emetics and 
stomach-pump. 

Belladonna. — No reliable chemical antidote ; tannin and animal 
charcoal have been employed. Physiological antidote, morphine, 
which may be administered subcutaneously. Usual treatment 
for narcotic posions. 

Bismuth Subnitrate. — Albumen, milk, sugar, mucilaginous drinks. 

Brucia. — Same treatment as for poisoning by nux vomica. 

Calabar Bean. — Physiological antidote, atropine cautiously ad- 
ministered hypodermically. 

Camphor. — Emetics, stimulants, wine, and opium. 

Cantharides. — Free emesis to be encouraged with warm demulcent 
drinks; castor oil ; demulcent injections. 

Carbolic Acid. — Saturated solution of saccharate of lime has been 
recommended, or Syrupus Calcis. Early use of the stomach- 
pump. Olive oil, flour and water, etc. Epsom salt and the solu- 
ble sulphates. 

Carbonic Acid Gas. — Artificial respiration, friction, stimulants, 
fresh air, and electricity. 



TREATMENT OF POISONING. 515 

Chloral. — Stomach-pump ; stomach well washed out with tea or 
coffee. Diffusible stimulants. General treatment same as for 
opium poisoning, or poisoning by chloroform. Keep patient warm. 

Chloroform. — In poisoning by liquid chloroform, use the stomach- 
pump and emetics. If collapse occur during anaesthesia, reverse 
the patient, practice artificial respiration. Ammonia by inhala- 
tion, ice in rectum, hypodermic injections of brandy and am- 
monia, etc. 

Chromium, Compounds of. — Magnesium carbonate or chalk, in milk, 
albumen, or water, followed by emetics. 

Citric Acid. — Alkaline carbonates, chalk, or magnesia. 

Cocculus Indicus. — Mucilaginous drinks, stimulants, and emetics. 

Colchicum. — Prompt emesis, castor oil, demulcents, opium and 
stimulants. 

Conium. — Mustard and warm water. Active stimulation, externally 
and internally. Atropine hypodermically. 

Copper, Preparations of. — Antidote, white of eggs, freely admin- 
istered, or milk. Vomiting should be aided by warm mucilagi- 
nous drinks ; stomach-pump if necessary. 

Corrosive Sublimate. — Albumen, mixed with water and given cop- 
iously, forms insoluble compound ; white of one egg neutralizes 
four grains of corrosive sublimate. Gluten, or wheat-flour paste, 
or milk, also employed. Free vomiting aided by warm diluent 
drinks ; stomach-pump to be used with caution — may produce 
perforation. 

Creasote. — Emetics or stomach-pump ; demulcent and mucilagi- 
nous drinks. 

Croton Oil. — Same general treatment as for otber irritant poisons, 
to counteract excessive vomiting and purging. Opium stimulants, 
demulcents. 

Curare. — Same general treatment as that mentioned for poisoning 
by narcotics ; artificial respiration, hot coffee, etc. 

Cyanide of Potassium. — See Hydrocyanic Acid. 

Digitalis. — Vegetable infusions containing tannic acid render the 
active principle insoluble. Give emetics and hot applications to 
surface. 

Ether, Vapor of. — Cold affusion ; exposure to current of air ; arti- 
ficial respiration. 

Gold, Preparations of. — Sulphate of iron ; mucilaginous drinks. 

Hydrochloric Acid. — See Muriatic Acid. 

Hydrocyanic Acid. — Mixture of protosulphate and sequisulphide 
of iron (ferrous and ferric sulphate), followed by solution of 
potassium carbonate. Being rapidly fatal, treatment must be 
instantaneous. Cold affusion ; cautious inhalation of ammonia 
and chlorine vapors ; stimulation externally and internally. 

Hyoscyamus. — Same general treatment as for poisoning by bella- 
donna and vegetable narcotics. 

Iodine. — Starch or flour, in water. 

Iron, Chloride and Sulphate. — Magnesia, copious diluent drinks. 

Lead Salts. — Zinc sulphate, producing free emesis, and forming 
insoluble lead sulphate. Milk and white of egg, given copiously, 
form insoluble compounds. Solutions of magnesium or sodium 



516 TREATMENT OP POISONING. 

sulphate, freely administered, act as antidotes and cathartics ; 
castor oil may also be administered. 

Lobelia. — Emetics, purgatives, stimulants. 

Methylene, Bichloride of. — Same treatment as for poisoning by 
chloroform vapor. 

Morphine. — See Opium. 

Muriatic or Hydrochloric Acid.— Solution of alkaline carbonates 
in water or milk ; magnesia or chalk suspended in milk ; soap- 
suds ; scrapings from whitewashed walls (in the absence of other 
articles) ; free use of barley water, oily emulsions, gruel and 
milk in large quantities. 

Nitrate of Potassium. — See Potassium. 

Nitric Acid and Nitromuriatic Acid.— Same treatment as already 
detailed for poisoning by muriatic acid. Dilute solution of sodium 
carbonate, or fluid magnesia, with water, and milk or demulcents 
may be given. 

Nitrous Oxide. — Same general treatment as for poisoning by chlo- 
roform vapor. 

Nux Vomica. — See Strychnine. 

Oil of Bitter Almonds. — Same treatment as for hydrocyanic-acid 
poisoning. 

Opium and its Preparations. — Antidotes, tannic acid and iodated 
iodide of potassium. Physiological antidote, solution of atropine 
or tincture of belladonna. Treatment, direct emetics, as large 
doses of zinc sulphate, repeated if necessary, or mustard and 
warm water, or stomach-pump. For the narcotic effect of the 
drug, affusion with cold water, walking the patient, arousing him 
by shaking and shouting ; flagellations ; enemataof strong coffee. 
If unsuccessful, electricity and artificial respiration. 

Oxalic Acid. — Avoid the use of alkalies or their carbonates, as 
they form poisonous salts with the oxalic acid. Give chalk or 
calcined magnesia, or its carbonate, suspended in water or milk, 
which forms insoluble and inert earthy oxalates ; or saccharated 
solution of lime. After treatment, mucilaginous drinks, lime- 
water, and oil ; warmth and stimulants. 

Phosphorus. — Free vomiting ; albuminous and mucilaginous drinks 
in which hydrate of magnesia is suspended. Oil, being a sol- 
vent of phosphorus, should be avoided. Old oil of turpentine 
(containing oxygen), oxygenated water, oxygen inhalations, cop- 
per sulphate, animal charcoal, have been employed as antidotes. 

Physostigma. — See Calabar Bean. 

Potassa. — Mild vegetable acids, as dilute vinegar or lemon juice ; 
demulcent drinks ; olive oil, in large quantities, produces a 
soap. Milk may be copiously administered. Stomach-pump 
should not be used. 

Potassium Bitartrate (cream of tartar). — Same treatment as for 
the nitrate. Dilute solution of potassium bicarbonate reduces 
bitartrate to harmless neutral tartrate. 

Potassium Cyanide. — Weak solution of ferrous sulphate converts 
it into Prussian blue ; otherwise, treatment similar to that for 
hydrocyanic acid. 



TREATMENT OF POISONING. 517 

Potassium Nitrate. — No direct antidote ; stomach pump ; free 
vomiting, and copious mucilaginous' drinks ; stimulants, opium, 
and coffee, if great depression exists. 

Prussic Acid. — See Hydrocyanic Acid. 

Silver, the Salts of.*— Albumen, milk. If nitrate, give the chlo- 
ride of sodium, followed by emetics. 

Soda, and its Preparations. — Same treatment as for potassa 
poisoning. 

Stramonium. — Same treatment as for poisoning by belladonna. 
Morphine should be administered hypodermically. 

Strychnine. — Bromide of potassium in very large doses. Hydrate 
of chloral, nitrite of amyl, and atropine have also been recom- 
mended. Prompt emesis by stomach-pump, or mustard and 
warm water, or mixture of ipecacuanha and zinc sulphate. In- 
halation of chloroform, continuously employed, may relieve 
tetanic rigidity. 

Sulphate of Indigo. — Calcined magnesia and milk, or fluid mag- 
nesia. 

Sulphuric Acid. — Same treatment as for poisoning by muriatic 
acid. Solution of sodium carbonate in milk and water. Stomach- 
pump must not be used. 

Tartaric Acid. — Same treatment as for poisoning by citric acid or 
oxalic acid. 

Tartar Emetic — See Antimony. 

Tobacco. — Stomach-pump or emetics ; whisky, strychnine, stimu- 
lating injections per anion, containing turpentine, or ammonia. 

Veratrum. — Rapid emesis, stimulants, with laudanum, or some 
other opiate. Tannin has been proposed as an antidote. 

Zinc Chloride. — Albumen given liberally. Free emesis, copious 
warm mucilaginous drinks, or stomach-pump. 

Zinc Sulphatb. — Tepid water, with milk and albumen ; infusions 
containing tannic acid. Stomach-pump. Laudanum and starch 
emetics. 

There are a number of so-called vegetable irritants, such 
as aloes, scammony, and jalap, which may give rise to 
toxical symptoms. Their effects should be treated on general 
principles, such as the employment of emetics, diluents, 
castor oil, opium, and fomentations. The same remarks 
apply also to the various articles of diet, such as meat, fish, 
lobsters, or fruits which occasionally produce similar results. 
Irritant gases, as chlorine, nitrous acid, or sulphurous acid 
vapor, etc., may act as poisons, and their effect should be 
treated by removal of the patient from the causes, cold 
affusion, and by antidotes as directed. The numerous 
poisonous fungi which may be taken into the stomach may 
also produce symptoms, and require treatment on general 
principles. 

Bites of venomous reptiles require special treatment ; the 
44 



518 



TABLE OF POISONS AND ANTIDOTES. 



wound may be sucked with impunity, provided there be no 
abrasion upon the lips or tongue. The limb above the point 
having a ligature placed around it, or compressed, the part 
involved may be excised or cauterized with the hot iron or 
nitric acid. In snake-bite a strong solution of permanganate 
of potassium should be injected with a hypodermic syringe 
into each puncture made by the fangs of the serpent. The 
intravenous injection of ammonia has also been advised. 
Stimulants, as ammonia or brandy, should also be freely 
given. The local treatment here detailed would also be 
applicable to bites of rabid animals. 

The following Table, from Taylor "On Poisons," gives a 
comprehensive review of the most approved antidotes for the 
several principal poisons noticed in the foregoing pages, 
which should be committed to memory : — 



NON-METALLIC POISONS. 



Mineral 
Acids. 



Vegetable 

Acids 

and their 

Alkaline 

Salts. 

Alkalies. 



Poisons. 



Sulphuric 

Nitric 

Hydrochloric 

Nitro- hydrochloric 

Oxalic 

Tartaric 

Potassium Binoxa- 
late 

Potassium Bitar- 
trate 

Potassa, soda, am- 
monia, and their 
carbonates 



Antidotes. 

Magnesia mixed with water or 

milk ; calcium carbonate ; 

compound chalk powder ; 

soda; potassa ; the fixed oils. 
Calcium carbonate (chalk or 

whiting). 

Calcium carbonate. Calcium 

sulphate and water. 
Sodium carbonate in solution. 

Vinegar, lemon-juice, citric 
acid, or oil. 



METALLIC POISONS. 



Arsenic 
nites. 



and soluble arse- 



Corrosive sublimate, and salts 
of mercury. 

Phosphorus. 

Baryta and its soluble salts. •< 
Barium carbonate. 



{ 



Hydrated peroxide of iron ; hy- 
drated magnesia ; solution of 
dialyzed iron. 

Mixture of oil and lime-water. 

Albumen, gluten, or flour, diffused 
in water or milk. 

Cupric sulphate ; old oil of tur- 
pentine ; water containing mag- 
nesia. 

Sodium, potassium, magnesium, 
or calcium sulphate. 

Mixture of magnesium sulphate 
and vinegar. 



TABLE OF POISONS AND ANTIDOTES. 



519 



Poisons. 
Alum. 

Soluble salts of lead. < 

Lead carbonate. 
Soluble salts of copper. j 

Tartar emetic. -j 

Antimony chloride. 

Salts of tin. 1 

Zinc sulphate, or acetate. < 

Ferrous sulphate. 
Silver nitrate. 



Antidotes. 

Sodium or ammonium carbonate. 

The alkaline, or soluble earthy 
sulphates. 

Magnesium sulphate and vinegar. 

Albumen, gluten, flour diffused in 
water ; milk. 

Decoctions and tinctures contain- 
ing tannic acid. 

Magnesia. 

Sodium carbonate ; magnesia. 

Milk ; sodium carbonate ; mag- 
nesia. 

Milk ; sodium carbonate ; mag- 
nesia. 

Sodium or ammonium carbonate. 

Sodium chloride, and emetics. 



NARCOTIC POISONS. 



Opium ; hyoscyamus. 



Prussic acid. 



f Emetics ; stomach-pump, cold af- 
fusion. Strong decoction of cof- 
fee ; electro-magnetism ; tannic 

i. acid. 

' Ammonia ; chlorine ; cold affusion ; 
iron and potassium carbonate 
(see p. 117); or cupric sulphate 
(1 Gm. followed by 0.5 Gm., 
every five minutes until vomit- 
ing is produced). 



MODES OF DISTINGUISHING SOME OF THE VEGETABLE 
ALKALOIDS WHEN IN POWDER. 

Treat the powder with nitric acid ; this is colored red by 
Brucine, Delphinine, Morphine, and by the Strychnine of 
commerce, but not the pure. If the reddened acid become 
violet on the addition of protochloride of tin, it is Brucine ; 
if it become black and carbonaceous, it is Delphinine. If the 
powder be fusible without decomposition, and decompose 
iodic acid, it is Morphine ; if it be not fusible without de- 
composition, and do not decompose iodic acid, it is Strych- 
nine. If the powder strike a green with nitric acid, it is 
Solanine ; if insoluble in ether, and do not redden nitric 
acid, it is Emetine ; if insoluble in ether, and do not redden 
nitric acid, but should melt and volatilize with heat, it is 
Atropine ; if thus affected by ether or nitric acid, but do not 
volatilize, it is Veratrine. (Griffith.) 



520 PTOMAINES. 

[Ptomaines. During decomposition of the human body 
substances are formed called Ptomaines, which give reactions 
very much like some of the above alkaloids. Their existence 
should put the examiner on his guard. Gautier declares that 
they may occur in the living body, and he has extracted a 
poison resembling that of serpents' from human saliva, and 
from the urine he has also obtained the so-called cadaveric 
alkaloids. Ptomaines are distinguished from the alkaloids 
veratrine, morphine, and codeine with difficulty, but a plan 
has been devised by Brouardel and Boutmy (Comptes Ren- 
dus, 92, p. 1056; Annales d'Hygiene, v. p. 497), by which 
this is accomplished by potassium ferricyanide and silver 
bromide as re-agents : " If a base be present, indicated by 
the formation of a precipitate with potassium iodo-mercurate, 
and this instantly change potassium ferricyanide into ferro- 
cyanide, giving a precipitate of Prussian blue on the addition 
of ferric-chloride, a ptomaine is present; whereas precipita- 
tion by the iodo-mercurate, coupled with the non-reduction 
of the ferricyanide to the ferrocyanide, shows that a vege- 
table alkaloid is being dealt with. Morphine and veratrine, 
of the vegetable alkaloids, are exceptions to the above reac- 
tion." This may be supplemented by the silver test. If a 
piece of photographic paper imbued with the bromide of 
silver be written upon with a quill pen dipped in a solution 
of the base, and the paper be placed in a dark room, and 
then washed successively with sodium hypo-sulphite and 
water, the characters traced upon the paper will be made 
manifest by reduction which has occurred, if a ptomaine be 
present." (Lond. Med. Record, vol. ix. p. 451.)] 



EPITOME OF THE NATIONAL FORMULARY 

ISSUED BY THE 

COMMITTEE OF THE AMERICAN PHARMACEUTICAL 
ASSOCIATION.' 



ELIXIRIA— ELIXIRS. N. F. 

(7/i prescribing the physician should place N. F. after the name of the 
preparation in order to avoid substitution.) 

The value of pleasant vehicles to mask or modify the taste of 
bitter and nauseous drugs is recognized by every prescriber. The 
following kinds of the National Formulary have been carefully 
selected, and embrace the most effective combinations of adju- 
vants and aromatics for disguising the different drugs for which 
they are recommended : — 

SIMPLE ELIXIRS. 

Elixir Aromaticum (Aromatic Elixir). 

An improved form of the original Simple Elixir, being a 
delicious compound of the choicest fruit flavors, Orange, 
Lemon, Coriander, and Star-anise. It contains about 25 
per cent, of Alcohol, and is especially valuable as a simple 
vehicle or diluent of tinctures and preparations not par- 
ticularly unpalatable. Being also prepared free from 
tannin it is the best vehicle for Tincture Chloride of Iron 
and all preparations of Iron. 
The following are similar to the above, and may be useful 
where a change in the flavor is desirable : — 
Elixir Anisi (Aniseed Cordial). 

A combination of Anethol, Fennel and Bitter Almond. 
Elixir Curassao (Curacao Cordial). 

A combination of CuraQao, Orris, a little Citric Acid and 
25 per cent, of Alcohol. 

1 From "The Physician's Manual of the National Formulary," 
compiled by C. S. Hallberg, Ph.G-., with additions. 

44* 



522 THE NATIONAL FORMULARY. 



ADJUVANT ELIXIRS. 

The following are intended as vehicles for Quinine and similar 
bitter substances, and as adjuvants for Tinctures and Fluid Ex- 
tracts of bitter and resinous drugs, such as Cinchona, Cascara 
Sagrada, etc. They all contain Glycyrrhiza, which, in the form 
directed in the N. F. (Russian Licorice Root, peeled), is most 
effective in masking the bitter taste of Quinine, etc., when directed 
to be simply suspended in the mixture without the use of acid for 
effecting solution. Acids precipitate the glycyrrhizin and destroy 
its power of masking the bitter taste : — 
Elixir Adjuvans. 

A combination of Orange, Wild Cherry, Glycyrrhiza, Cori- 
ander, and Caraway. 
Except for the exhibition of Quinine this is the most effective 
of the adjuvant Elixirs. 
Elixir Glycyrrhiza (Elixir of Licorice). 

A solution of Licorice in Aromatic Elixir, the most effective 
vehicle for Quinine. 
Elixir Glycyrrhiza Aromaticum. 

Elixir of Licorice, with the addition of strong aromatics. 
Elixir Taraxaci Compositum. 

An improved form of this well-known compound, useful as a 

mild adjuvant and laxative. 

Elixir Eriodictyi Akomaticum (Arom. Elixir Yerba Santa 

— Elixir Corrigens). 

A solution of Yerba Santa in Comp. Elixir of Taraxacum, 

intended as a vehicle for Quinine and other bitter remedies. 

MEDICINAL ELIXIRS. 

These comprise the Elixirs mostly in use ; also, a number of 
preparations in which the prescriber will find satisfactory substi- 
tutes, designated by scientific titles and of definite strength and 
uniform composition, intended to replace various nostrums. The 
figures appended indicate the number of grains of active drugs in 
1 fiuidrachm. 

Elixir — 

Acidi Salicylict ...... grs. 5 

Ammonii Bromidi ...... grs. 5 

Ammonii Yalerianatis. 

The odor and taste of the salt being well cov- 
ered by the addition of vanilla and a little 
chloroform ....... grs. 2 

Ammonii Yalerianatis et Quinina. 

The above, with Quinine hydrochlorate . . gr. ^ 



THE NATIONAL FORMULARY. 523 

Elixir — 

Apii Graveolentis Compositum (Celery Com- 
pound). 
A combination to replace a patent medicine con- 
taining fluid extracts of Celery, Erythroxylon, 
Kola and Viburnum, each .... grs. 4 
Bismuthi. 

Citrate of Bismuth and Ammonium . . grs. 2 

Buchu grs. 7£ 

Buchu Compositum. 

Buchu, Cubeb, Juniper and Uva Ursi, com- 
bined ........ grs. 15 

Buchu et Potassii Acetatis. 

Elixir Buchu, with Acetate of Potassium . grs. 5 

Caffeix.e. 

Caffeine (in solution in Hydrobromic Acid) . gr. 1 

Calcii Bromidi grs. 5 

Calcii Hypophosphitis ..... grs. 2 
Calcii Lactophosphatis. 

Lactate of Calcium (in Phosphoric Acid) . gr. 1 

Catharticum Compositum. 

One fiuidrachm contains Senna 7^ grains, Podo- 
phyllum 4 grains, Leptandra and Jalap each 
3 grains, 7^ grains Rochelle Salts and I gr. 
Bicarbonate of Sodium. The mixture should 
be shaken when dispensed. Average dose for 
an adult is f£ij (8. Gm.). 
Chloroformi Compositum. 

A mixture of equal parts of Chloroform, Tinc- 
ture of Opium, Spirit of Camphor, Aromatic 
Spirit of Ammonia and Alcohol, flavored with 
Cinnamon. The old title, " Chloroform Pare- 
goric," is recommended to be abandoned for 
the above. Each tluidrachm represents 1 grain 
. Opium and 11 minims Chloroform. 

Cinchona: (Elixir Calisaya). (See note.) 
This preparation is from the best Calisaya Bark, 
containing about 6 per cent, of alkaloids, 4 of 
which are Quinine. It is preferable to prepa- 
rations made from Quinine and the cheaper 
alkaloids in being a more agreeable and effec- 
tive antiperiodic tonic. (Each fiuidrachm 
represents 14 grains of Yellow Cinchona.) 

This Elixir is used in all the Compound Elixirs of Cin- 
chona, being more than double the strength prescribed by 
the N. F. 



524 THE NATIONAL FORMULARY. 

Elixir — 

Cinchona Detannatum (same as above, with- 
out Tannin Acid, so that it can be pre- 
scribed with Iron). 
Cinchona et Hypophosphitum, (as above, with) 

Hypophosphites of Calcium and Sodium, each . gr. 1 
Cinchona et Ferri (Calisaya and Iron — Fer- 
rated Elixir of Calisaya). 
Phosphate Iron ...... grs. 2 

Cinchona, Ferri, Bismuthi et Strychnine. 

Phosphate of Iron ...... grs. 2 

Citrate of Bismuth and Ammonium . . gr. 1 

Strychnine sulphate . . . . • g r - too 

Cinchona, Ferri et Bismuthi. 

Phosphate of Iron ...... grs. 2 

Citrate of Bismuth and Ammonium . . gr. 1 

Cinchona, Ferri et Calcii Lactophos- 
phatis. 
Phosphate of Iron ...... grs. 2 

Lactophosphate of Calcium, about . . . gr. f 

Cinchona, Ferri et Pepsini. 

Phosphate of Iron grs. 1£ 

Pepsin, N. F. (1.500) gr. 1 

Cinchone, Ferri et Strychnine. 

Phosphate of Iron ...... grs. 2 

Sulphate of Strychnine g r< Too 

Cinchone, Pepsini et Strychnine. 

Containing smaller quantities of the Cinchona 
Alkaloids, Pepsin N. F., and Sulphate of 
Strychnine . . . . . . • g r - too 

CORYDALIS COMPOSITUM. 

Containing of Corydalis, Stillingia, Iris and 
Xanthoxylum, combined 

Potassium Iodide ..... 
Erythroxyli (Coca). 

Leaves, Erythroxylon Coca 
Erythroxyli et Guarane. 

Erythroxylon and Guarana, of each 
Eucalypti. 

Leaves, Eucalyptus Globulus . 
Euonymi (Wahoo). 

Bark of root, Euonymus Atropurpureus . 
Ferri Hypophosphitis. 

Hypophosphite of Iron (ferric) 
Ferri Lactatis ..... 



grs. 


15 


grs. 


3 


grs. 


n 


grs. 


n 


grs. 


n 


grs. 


H 


gr. 


i 


gr. 


i 



THE NATIONAL FORMULARY. 525 

Elixir — 

Ferri Phosphatis. 

Phosphate of Iron (U. S. P.) . . . grs. 2 

Ferri Phosphatis, Cinchonidine et STRYCH- 
NINE. 
Phosphate of Iron 2 grains, Cinchonidine 1 

grain, Sulphate of Strychnine . . • g r - Too 

Ferri Phosphatis, Quinine: et Strychnine. 
Phosphate Iron, 2 grains ; Quinine Hydrochlo- 

rate . . . . . . . . gr. 1 

Sulphate of Strychnine ..... gr. T J 

Ferri Pyrophosphatis grs. 2 

Ferri, Quinine et Strychnine. 

Ferric Chloride, Quinine Sulphate, of each . gr. 1 
Sulphate of Strychnine . . . . . gr. T ^ 

Frangule (Buckthorn). 

Bark, Rhamnus Frangula .... grs. 15 

Gentiane ....... grs. 2 

Gentiane et Ferri Phosphatis (Ferrophos- 
phated Elixir of Gentian). 
Phosphate of Iron . . . . . . gr. 1 

Gentian . . . . . . . . grs. 2 

Gentiane cum Tinctura Ferri Chloridi. 
Tincture Citro-chloride of Iron, 5 minims, 
equivalent to § grains ferric chloride. Gen- 
tian ........ 

Grindelie. 

Grindelia Robusta ...... 

Guarane. 

Paullinia Sorbilis ...... 

HUMULI 

Hypophosphitum. 

Hypophosphite of Calcium .... 

Hypophosphites of Sodium and Potassium, each 
Hypophosphitum cum Ferro. 

Hypophosphites of Calcium and Sodium, each 

Hypophosphites of Potassium and Iron, each . 
Lithii Bromidi ...... 

LlTHII ClTRATIS 

Lithii Salicylatis ..... 

Malti et Ferri. 

Phosphate of Iron, 1 grain, and Malt Extract . grs. 15 
Pepsini. 

Pepsin, N. F. (1 to 500) . . . . gr. 1 



grs. 


2 


grs. 


4 


grs. 


11 


grs. 


n 


grs. 


3 


gr. 


1 


gr. 
gr. 


1 

i 

2- 


grs. 


5 


grs. 


5 


grs. 


5 



526 THE NATIONAL FORMULARY. 

Elixir — 

Pepsini et Bismuthi. 

Pepsin, 1 grain ; Citrate of Bismuth and Am- 
monium ....... orrs. 2 

o 

Pepsini, Bismuthi et Strychnine. 

Elixir Pepsin and Bismuth and Strychnine . gr. T ^ 
Pepsini et Ferri. 

Elixir of Pepsin and Tincture Citro-chloride of 

Iron, equal to Ferric chloride . . . gr. j 
Phosphori. 

Phosphorus, in glycerin, alcohol and elixir . gr. 3 
Phosphori et Nucis Vomica:. 

Elixir Phosphorus, with Tincture Nux Vomica grs. 2 
Picis Compositum. 

A combination of Syrup of Prunus Virginia, and 
of Tolu, with Methylic Alcohol with 

Sulphate of Morphine . . . . . gr. 7 
Pilocarpi (Jaborandi). 

Leaves, Pilocarpus pennatifolius . . . grs. 3{ 

POTASSII ACETATIS grs. 5 

POTASSII ACETATIS ET JUNIPERI. 

Acetate of Potassium, 5 grains ; Juniper . . grs. 7^ 

POTASSII BllOMIDI. 

Bromide of Potassium, effectually masked in Ad- 
juvant Elixir ...... grs. 10 

Quinine Compositum. 

Sulphate of Quinine, £ grain ; Cinchonidine 
and Cinchonine, each ..... 

Chiefly intended as a substitute for Elixir Cin- 
chona when the administration of other constitu- 
ents of the bark may not be desirable. 
Quinine et Phosphatum Compositum. 

Quinine sulphate, | grain; Phosphate of Iron, 

1 grain ; and Lactophosphate of Calcium . gr. f 

Quinine Valerianatis et Strychnine. 

Valerianate of Quinine . ... . . gr. 1 

Sulphate of Strychnine . . . . . gr. T ^ 

Khamni Purshiane (Cascara Sagrada). 

Bark, Rhamnus Purshiana, its bitterness effectu- 
ally masked with Elixirs Glycyrrhiza and Ta- 
raxacum Compound ..... grs. 15 

Rhamni Purshiane Compositum (Laxative 
Elixir — Elixir Purgans). 

Cascara Sagrada, 7£ grains ; Senna and Juglans, 
each, 5 grains. Associated with aromatics 
and correctives. Adult dose, one to two 
fluidrachms. 



g r - 



THE NATIONAL FORMULARY. 527 

Elixir — 
Rhei. 

Sweet Tincture of Rhubarb, representing Rhu- 
barb ........ grs. 2\ 

Rhei et Magxesii Acetatis. 

Acetate of Magnesium, 4 grains ; Rhubarb . grs. 1\ 
Rubi Compositum (Blackberry Compound). 1 

Blackberry Root, Galls and Cinnamon (Sai- 
gon), in equal proportions (.10). 
Combined with smaller quantities of Cloves, 

Mace and Ginger, in Blackberry Juice and 

Syrup. 
Sodii Bromidi. 

Bromide of Sodium, nicely masked in Adjuvant 

Elixir ........ grs. 10 

Sodii Hypophosphitis ..... grs. 2 

Sodii Salicylates grs. 5 

To be freshly prepared when required for use. 
Stillixglu Compositum. 

• Compound Fluid Extract of Stillingia, X. F. . grs. 15 
Strychxix^e Valeriaxatis .... 
Turxera (Damiana). 

Leaves, Turnera Aphrodisiaca 
Yiburxi Opuli Compositum (Compound Elixir 
of Cramp bark). 

Viburnum Opulus, Aletris Farinosa, each 

Trillium (Beth Root) 

Viburxi Pruxifolii (Black Haw) . 
Zixci Valeriaxatis. 

Valerianate of Zinc ..... 



g r - 


TOff 


grs. 


H 


grs. 


5 


grs. 


10 


grs. 


n 



EMULSIOXES-EMULSIONS. X. F. 

Emulsions should, of all pharmaceuticals, be prepared within 
a reasonable period previous to the time of dispensing. A true 
emulsion should contain the oil simply suspended in the form of a 
mechanical mixture, which, from its very character, cannot with- 
stand the effects of variation in temperature any better than a 
natural emulsion, such as milk or emulsions of Almonds, Gum- 
Resins, etc., and consequently quickly degenerates or spoils. 

1 Cordiale Rubi Fructus (Blackberry Cordial) contains fresh 
blackberry juice (3 parts) witb a tincture made of dilute alcohol of 
Cinnamon, Cloves and Nutmeg (2 part6), and simple syrup (3 parts). 



528 THE NATIONAL FORMULARY. 

An emulsion may be perfect, that is, the oil globules entirely- 
extinguished, yet a separation similar to that occurring in Milk 
will take place, which, though in its first stage not so objection- 
able, will eventually impair the medicinal value of the prepara- 
tion. These reasons are, it is believed, sufficient to condemn the 
various "ready-made" or patent emulsions, and to justify the 
physician in prescribing such as are kept on hand by the pharma- 
cist, in smaller quantities, prepared according to these formulas. 

The Emulsifying Agents directed in the N. F. are, in order 
of preference, Irish Moss, Acacia, Glyconin (Glycerite of Egg 
Yolk), Tincture of Quillaia and Dextrin Mucilage. The first 
three are mostly employed, the last two but seldom. 

The Cod Liver Oil Emulsions of the N. F. are prepared with 
Irish Moss unless otherwise specified. 

The following are flavors employed : (1) Gaultheria, (2) gaul- 
theria and sassafras, (3) aromatic spirit, (4) gaultheria, bitter 
almond and coriander, (5) gaultheria, sassafras and bitter almond, 
(6) gaultheria and bitter almond, (7) oil of neroli, bitter almond 
and cloves. Unless otherwise specified that designated in No. 5 
will be employed in these Emulsions. 

The following is a typical formula for an emulsion prepared 
with Irish Moss : — 

Emulsio Olei Morrhu^:, N. F. 

I£. Olei Morrhuie ^iv. 

Mucilaginis Chondri (N. F.) . . ^iiss. 

Syrupi Tolutanae £j. 

Aquae q. s. ad Jviij. 

The Oil is emulsified by adding it to the mucilage, contained in a 
bottle, in divided portions, shaking after each addition, then adding 
the syrup, water and any desired flavoring. 

A typical formula for emulsions, with Acacia, is : — 

I£. Olei Morrhuae . . . ^iv. 

Acaciae pulv. . . . jfvj. 

Syrupi Tolutanae . . J;j. 

Aquae . . q. s. ad ^viij. 

Emulsify by trituration in a mortar, and add the flavoring. 

These formulas may be useful as indicating the form of pre- 
scription for any combination desired. Hypophosphite Salts or 
any medication desired may usually be dissolved in the water 
directed in the formula should a different preparation be indi- 
cated from any of the following Emulsions of the N. F. : 

Emulsio — 

Olei Morrhuie cum Calcii et Sodii Phosphatibus. 

Phosphate of Calcium, Phosphate of Sodium, of each 1 
grain, in 1 fluidrachm. 



THE NATIONAL FORMULARY. 529 

Emulsio — 

Olei Morrhui: cum Calcii Lactophosphate. 

Lactophosphate of Calcium, 3 grains in one fluidrachm. 
Olei Morrhu.e cum Calcii Phosphate. 

Phosphate of Calcium 2 grains in one fluidrachm. 
Olei Morrhu.e cum Hypophosphite. 

The Hypophosphite Salt, or any combination, of the fol- 
lowing : Calcium, Potassium, Sodium or Iron, to be 
directed by the prescriber, 8 grains to the fluid ounce. 
Olei Morrhu.e cum Pruxo Virgixiaxa. 

Wild Cherry (Fluid Ext.), £ fluidrachm to one fluid ounce. 
Olei Morrhu^e cum Extracto Malti. 
Contains 40 per cent. Extract of Malt. 
Phosphatica (Phosphatic Emulsion). 

Prepared with Glycerite of Egg Yolk, and contains in one 
fluid ounce : Cod Liver Oil, 2 fluidrachms ; Dilute Phos- 
phoric Acid, 22^ minims ; Jamaica Rum, flavored with 
Bitter Almond and Orange Flower Water. 
Olei Terebixthix^e. 

Containing 1 fluidrachm Oil of Turpentine to the fluid 
ounce, prepared according to the following formula : 

$. Olei Terebinthinae .... giv. 
Acacias, pulv gr. xxx. 

Vitelli Ovi (Egg Yolk) . . no. 1. 
Elixir Aromaticas, N. F. . . giv. 
Aquas Cinnamomi . . q. s. ad ^iv. 

Make an Emulsion by trituration in a mortar. 

Olei Ricixi. 

One fluid ounce contains 2£ fluidrachms Castor Oil, dis- 
guised by the addition of Vanilla. 
Chloroformi. 

One fluidrachm contains of Chloroform 2\ minims. Not a 
permanent emulsion, but a mixture, which requires 
shaking before use; prepared by agitating the chloroform 
with three-fourths its volume of Tincture Quillaia, N. 
F., and adding powdered Acacia, then water. 

EMULSIOXS OF VOLATILE OILS. 

The N. F. gives the following general formula : — 

Any Volatile Oil . . . . fl. drs. 4. 
Acacia, powdered .... grs. 120. 

Syrup fl. oz. 1. 

Water . . . enough to make fl. oz. 4. 

Make an emulsion bv agitating the oil with the acacia in a dry 
45 



530 THE NATIONAL FORMULARY. 

bottle, adding the syrup, and finally incorporate the water by 
agitation. 

To render an Emulsion of a Volatile Oil more permanent the 
N. F. recommends the addition of one-half as much of a bland 
fixed oil (Almond) as of the quantity of volatMe oil prescribed. 
This makes a very satisfactory Emulsion. 



AQILE— WATERS. N. F. 

Aqua Chloroformi. 

A solution of § per cent, of Purified Chloroform in Distilled 
Water. (3 minims to the fluid ounce.) 

Chloroform "Water, aside from its medicinal properties, is an 
efficient preservative agent, and forms a good solvent in place 
of water for preparing solutions intended to be kept free from 
micro-organisms, as, for example, those for hypodermic use. 

Aqua Hamamelidis (Witch Hazel Extract). 

Obtained by distilling the fresh young twigs of Hamamelis 
with water containing 15 per cent, of Alcohol. 
Aqua Sedativa (Eau Sedatif de Raspail). 

A mixture of Spirits of Camphor (TH.90), and Sodium 
Chloride (3j), in Water containing about 1 per cent. Am- 
monia. (One pint.) 



EXTRACTA FLUID A— FLUID EXTRACTS. N. F. 

The following Fluid Extracts represent, in addition to those 
officinal, most of the drugs employed in this form. Carefully 
prepared after the processes given in the N. F., from the best 
quality of crude drug, they represent uniformly the respective 
drugs, minim for grain. 

Unless otherwise indicated the dose of the following Fluid 
Extracts is from one-half to one fluidrachm. 

EXTRACTUM FLUIDUM — 

Adonidis. — Root of Adonis vernalis L. (Bird's Eye). 
Aletridis. — Rhizome of Aletris farinosa L. (Stargrass). 
Angelica Radicis. — Root of Archangelica L. (Angelica). 
Apii Graveolentis. — Seed of Apium graveolens L. (Celery). 
Apocyni Cannabini. — Root of Apocynum cannabinum L. 

(Canadian Hemp). 
Aralia: Racemose. — Root of Aralia racemosa L. (American 

Spikenard). 



THE NATIONAL FORMULARY. 531 

Extract ujvi Fluidum — 

Arnica: Flo rum. — Flowerheads of Arnica montana L. 

(Arnica). 
Asclepiadis Tuberose. — Root of Asclepias tuberosa L. 

(Pleurisy Root). 
Aspidospermatis. — Bark of Aspidosperma Quebracho, Sch. 

(Quebracho). 
Berberidis Vulgaris. — Bark of the root of Berberis vulgaris 

L. (Barberry). 
Boldi. — Leaves of Peumus Boldus, Molino (Boldo). 
Buchu Compositum. — A combination of Buchu, 10 ; Cubeb, 

1 ; Juniper, 2 ; Uva Ursi, 2 ounces, in one pint. 
Calendula. — Flowering herb of Calendula officinalis L. 

(Marigold). 
Camellia. — Leaves of Camellia Thea, Link (Tea). The best 

quality of commercial black tea, "Formosa Oolong," to be 

employed for this preparation. 
Caulophylli. — Rhizome and rootlets of Caulophyllum thalic- 

troides Mich. (Blue Cohosh). 
Coffe^e Viridis. — Unroasted Seeds of Coffea Arabica L. 
Coffee Tost.e. — Roasted Seeds of Coffea Arabica L. 

The N. F. recommends equal portions of Java and Mocha to 

be employed in preparing the fluid Extracts of Coffee. 
Convallarle Florum. — Flowers of Convallaria majalis L. 

(Lily of the Valley). Dose, from 10 to 20 min. 
Convallarle Radicis. — Rhizome of Convallaria majalis L. 

(Lily of the Valley). Dose, from 10 to 20 min. 
Coptis. — Rhizome of Coptis trifolia, Salisb. (Goldthread). 
Corktus Circinat^e. — Bark of Cornus circinata, L'Her. 

(Green Osier). 
Corydalis. — Tubers of Dicentra Canadensis, De C. (Turkey 

Corn). 
Coto. — Coto bark. Undetermined tree. Dose, from 5 to 15 

min. 
Eriodictyi. — Leaves of Eriodictyon Californicum, Benth. 

(Mountain Balm ; Yerba Santa). 
Fuci. — Thallus of Fucus vesiculosus L. (Bladder- wrack). 
Helianthemi. — Herb of Helianthemum Canadense, Mich. 

(Frost- wort). 
Humuli. — Strobiles of Humulus Lupulus L. (Hops). 
Hydrangea. — Root of Hydrangea arborescens L. (Seven 

Barks). 
Jalap.e. — Tuber of Exogonium purga, Benth. (Jalap). Dose, 

from 15 to 20 min. 



532 THE NATIONAL FORMULARY. 

EXTRACTUM FLUIDUM — 

Juglandis. — Bark of the root of Juglans cinerea L. (But- 
ternut.) 

Juniperi. — Fruit of Juniperus communis L. 

Kava. — Root of Piper methysticum, Forster (Kava; Kava- 
kava ; Ava). 

Lappa. — Root of Lappa officinalis, Alb. (Burdock). 

Malti.— (Fluid Extract of Malt.) 

Menyanthis. — Leaves of Menyanthes trifoliata L. (Buck- 
bean. — Trifolium fibrinum, Germ. Ph.). 

Petroselini Radicis. — Root of Petroselinum sativum, Hoff- 
man (Parsley). 

Phytolacca. — Root of Phytolacca decandra L. (Poke 

Root). Dose, from 10 to 30 min. 
Quillaia. — Bark of Quillaia saponaria, Molina (Soap Bark). 

Seldom used internally. 
Rhamni PurshianyE. — Bark of Rhamnus Purshiana, De C. 

(Cascara Sagrada). 
Rhei Aromatic um. — A combination of Rhubarb, Cinnamon, 

Cloves and Nutmeg. 
Scoparii. — Tops of Sarothamnus Scoparius, Koch (Broom). 
Sp:js t n.e Deodoratum. — (Aqueous Fluid Extract of Senna.) 

This preparation is free from the objectionable " griping" 

qualities of the ordinary fluid extract. 
Sterculia. — Seeds of Sterculia acuminata, R. Brown (Cola ; 

or Kola). 
Stillingia Compositum. — (Stillingia Comp.) Stillingia, 

Corydalis, each 4 ozs. ; Iris, Sambucus, Chimaphila, each 2 

ozs. ; Coriander, Xanthoxylum Berries, each 1 oz. 
Trillii. — Rhizome of Trillium erectum L. (Bethroot). 
Turners. — Leaves of Turnera microphylla, De C. (Dami- 

ana). 
Urtica. — Root of Urtica dioica L. (Nettle). 
Verbasci. — Leaves (and flowers) of Verbascum Thapsus L. 

(Mullein). 
Verbena. — Root of Verbena hastata L. (Vervain). 
Viburni Opuli. — Bark of Viburnum Opulus L. (Cramp 

Bark). 
Zea. — Stigmatum maydis — Corn Silk — Stigmata of Zea Mays 

J j. (Indian Corn). 



Extr actum Ferri Pomatum. — Ferri Malas Crudus (Fer- 
rated Extract of Apples, P. Ger.). 



THE NATIONAL FORMULARY. 533 

Extractum Glycyrrhiz^e Depuratum. — Succus Liqui- 
ritiae, P. Ger. (Purified Extract of Licorice). Prepared 
by extraction from " Stick" Licorice, and should not be 
confounded with the Pure Extract Licorice, U. S. P., 
prepared direct from the root, which is far superior. 



GLYCERITi— GLYCERITES. N. F. 

Glyceritum — 

Acidi Tannici. — Containing Tannic Acid 20 per cent, in 
Glycerin ; practically identical in strength with the Glycer- 
iteof U. S. P. of 1870. 

Bismuthi. — Liquor Bismuthi Concentratus (Concentrated So- 
lution of Bismuth). Each fluidrachm contains 16 grains of 
Citrate of Bismuth and Ammonium. This preparation is 
a convenient form of Bismuth for combining with other 
preparations. 

Boroglycerini. — Glycerite of Glyceryl Borate (Solution of 
Boroglyceride). Boric Acid, in powder, 62 parts ; Glyc- 
erin enough to make 200 parts ; representing 50 per cent., 
by weight, of solid Boroglycerin. A clear, viscid liquid, 
more readily soluble in, and miscible with other liquids 
than the solid Boroglycerin. 

Hydrastis.— (Fluid Ext. Golden Seal, aqueous.) This 
preparation contains no Alcohol, and represents the active 
principles of the drug, soluble in 50 per cent. Glycerin, 
minim for grain. 

Pp:psini. — (Glycerole of Pepsin.) Each fluidrachm represents 5 
grains of Pepsin (N. F.), equivalent to a theoretical diges- 
tive strength of 2500 grains of coagulated albumen. 

Picis Liquids. — (Tar.) Containing about 5 grains of Tar. 

Tragacanth/E. — Containing about 12 percent, of tragacanth. 



Infusum Gentianae Compositum Fortius. — For preparing In- 
fusum Gentianae Compositum mix 1 volume of this prepara- 
tion with 3 volumes of water. 

Infusum Rosae Compositum. — (Compound Infusion of Rose, P. 
Br.) An infusion of Red Rose in diluted Sulphuric Acid, 
Sugar and Water. 

Decoctum Aloes Compositum. — (Comp'd Decoction of Aloes ) 
Contains 4 grains of the aqueous extract of aloes and about 
two drachms of compound tincture of cardamom, with myrrh, 
saffron, licorice, and potassium carbonate (2 grs.) in each fluid 
ounce. 

45* 



534 THE NATIONAL FORMULARY. 

Lac Fermentatum. — (Kumyss.) Cow's Milk, fresh, 32 fluid 
ounces ; Yeast, semi-liquid, 60 minims ; Sugar, 1 troy ounce. 
Dissolve the Sugar in the Milk, contained in a strong bottle, 
add the Yeast, then cork the bottle securely and keep it at a 
temperature between 23° and 32° C. (75° to 90° F.), for six 
hours ; then transfer it to a cold place. 



LINIMENT A— LINIMENTS. N. F. 

LlNIMENTUM 

Aconiti et Chloroformi. — Tincture of Aconite and Chloro- 
form, each, 2 fl. ozs. ; Soap Liniment, 19 fl. ozs. 

Ammonii Iodidi. — Iodine, 30 grs. ; Oil of Rosemary, Oil of 
Lavender, each 110 mins. ; Camphor, 220 grs. ; Water of 
Ammonia, If fl. oz. ; Alcohol, enough to make 16 fl. ozs. 
On standing, it becomes colorless. 

Iodi. — (Similar to Ph. Br.) Iodine, 900 grs. ; Iodide of 
Potassium, 360 grs. ; Glycerin, £ fl. oz. ; Water, 1 fl. oz. ; 
Alcohol, enough to make 16 fl. ozs. 

Opii Compositum. — (Canada Liniment.) Tincture of Opium, 
1£ fl. oz. ; Camphor, 120 grs. ; Alcohol, 4 fl. ozs. ; Oil of 
Peppermint, 180 mins. ; Water of Ammonia, 6 fl. ozs. ; 
Oil of Turpentine, enough to make 16 fl. ozs. 

Saponato Camphoratum. — (Opodeldoc. Solid Opodel- 
doc.) White Castile Soap, l£ tr. oz. ; Camphor, £ tr. 
oz. ; Alcohol, 20 fl. ozs. ; Oil of Th) me, 30 mins. ; Oil of 
Rosemary, 60 mins. ; Water of Ammonia, Fort., 1 fl. oz. 

Terebinthin^e Aceticum. — (Linimentum Album. Stokes' 
Liniment. St. John Long's Liniment.) Oil of Turpen- 
tine, 3 fl. ozs. ; Fresh Egg, 1 ; Oil of Lemon, 60 mins. ; 
Acetic Acid, 300 mins. ; Rose Water, 2^ fl. ozs. 

Tiglii. — (Linimentum Crotonis, P. Br.) Croton Oil, 2 fl. 
drachms ; Oil of Cajuput, 7 fl. drachms ; Alcohol, 7 fl. 
drachms. 

Tiglii Compositum. — Croton Oil, 1 fl. oz. ; Oil of Sassafras, 
1 fl. oz. ; Oil of Turpentine, 1 fl. oz. ; Oil of Olive, 2 fl. 
ozs. 



Lotto Adstringens. — (Warren's Styptic.) A mixture of Sul- 
phuric Acid, Oil of Turpentine and Alcohol. 

Lotio Flava. — (Yellow Wash — Aqua Phagedaenica Flava, P. 
Ger.) Corrosive Chloride of Mercury, 24 grains, in Lime 
Water, 16 fl. ozs. 



THE NATIONAL FORMULARY. 535 

Lotio Nigra. — (Black Wash — Aqua Phagedseniea Nigra, P. Ger.) 

Mild Chloride of Mercury, 64 grains, in Lime Water, 16 fl. 

ozs. 
Lotio Plumbi et Opii. — (Lead and Opium Wash.) Acetate of 

Lead, 120 grains; Tincture of Opium, ^ fl. oz., in Water, 

16 fl. ozs. To be shaken when dispensed. 



LIQUORES— LIQUORS. N. F. 

Liquor — 

Acidi Phosphorici Compositus. — (" Acid Phosphates.") 

Aluminii Acetatis. — (Aluminii Acetici, P. Ger.) Con- 
tains 8 per cent, of basic Acetate of Aluminium. 

Aluminii Acetico-Tartratis. — Contains about 50 per 
cent, of dry, so-called Acetico- Tartrate of Aluminium, 
which may be obtained by evaporating the solution. 

Ammonii Acetatis Concentratis. — About four times the 
strength of the officinal Liquor Ammonii Acetatis. When 
dispensed, it is suggested that it be diluted with Carbonic 
Acid W'ater, or be directed to be diluted with this at the 
time of administration. 

Ammonii Citratis Fortior. — Each fluidrachm contains 
about 40 grains of Citrate of Ammonium. Liquor Ammonii 
Citratis (P. Br.) may be prepared from this solution by 
mixing one vol. of it with four vols, of AVater. 

Bismuthi. — Each fluidrachm represents 1 grain of Citrate of 
Bismuth and Ammonium. 

Bromi. — (Smith's Solution of Bromine.) Bromine, 20 per 
cent. ; Bromide of Potassium, 10 per cent. ; Water. 

Calcis Sulphurate. — (Solution of Oxysulphuret of Cal- 
cium. — Vleminck's Solution, or Lotion.) 

Cupri Alkalinus. — (Fehling's Solution.) 
I. The Copper Solution. 
Sulphate of Copper, pure .... 34.639 gm. or grains 505 
Distilled Water, . . enough to make 500 c.c. — fl. ozs. ]6 

II. The Alkaline Solution. 

Tartrate of Potassium and Sodium . . 173 gm. — grains 2520 

Soda (U. S. P. 1880) 60 gm.— troy ozs. 2 

Distilled Water . . enough to make 500 c.c. — fl. ozs. 16 

Keep both solutions, separately, in small well-stoppered vials, 
in a cool and dark place. For use, mix exactly equal volumes of 
both solutions, by pouring the copper solution into the alkaline 
solution. Ten c.c. of the mixture prepared by metric weight and 
measure correspond to 0.05 gm. of glucose. Of the mixture pre- 



536 THE NATIONAL FORMULARY. 

pared by apothecaries' weight and measure, 210 minims correspond 
to 1 grain of glucose. 

Liquor Electropoiecus. — (Battery Fluid.) 

A. For the Carbon and Zinc Battery. I. (For ordinary use.) — 
Bichromate of Potassium, in powder, 6 troy ounces; Sulphuric 
Acid, commercial, 6 fluidounces ; Water, cold, 48 fluidounces. 
II. (For use with the Galvano-Cautery.) — Bichromate of Sodium, 
in powder, 6^ troy ounces; Sulphuric Acid, commercial, 14 fluid- 
ounces ; Water, cold, 48 fluidounces. 

Pour the Sulphuric Acid upon the powdered Bichromate and 
stir the mixture occasionally during one hour. Then slowly add 
the Water. Bichromate of Sodium is more soluble than the 
Potassium Salt, and also much cheaper. When it cannot be 
obtained, the Potassium Salt may be substituted for it, weight for 
weioht. 

B. For the Leclanche' Battery. — Chloride of Ammonium, 6 tr. 
ozs. ; Water, enough to make 20 fl. ozs. ; dissolve the salt in the 
Water. 

Liquor — 

Extracti GlycyrrhizvE. — Each fluidrachm represents 15 
grains of dry Extract of Glycyrrhiza. 

Ferri Hypophosphitis. — (Solution of Ferric Hypophos- 
phite). About 6 minims represent 1 grain of Hypophos- 
phite of Iron. 

Ferri Iodidi. — Each fluidrachm contains about 15 grains of 
Iodide of Iron (ferrous). On mixing 1 volume of this 
Solution of Todide of Iron with 5 volumes of Syrup, the 
product will contain about 60 grains of Iodide of Iron 
(ferrous) in each fluidounce, and will be practically iden- 
tical with the officinal Syrup of Iodide of Iron. 

Ferri Oxysulphatis. — (Oxysulphate of Iron.) 

Ferri Protochloridi. — (Solution of Ferrous Chloride.) 
Each fluidrachm represents about 20 grains of Protochloride 
of Iron (ferrous chloride). 

Hydrargyri et Potassii Iodidi. — (Solution of Iodide of 
Mercury and Potassium — Channing's Solution.) 

Red Iodide of Mercury, 72 grs. ; Iodide of Potassium, 
56 grs., in Distilled Water, 16 fl. ozs. 

Hypophosphitum. — Each fluidrachm contains 2 grains of 
Hypophosphite of Calcium, 1| grains of Hypophosphite of 
Sodium, and 1 grain of Hypophosphite of Potassium. 

Iodi Carboeatus. — (Boulton's Solution. "French Mix- 
ture.") — Comp. Tincture of Iodine, 110 mins. ; Carbolic 
Acid, 40 grs. ; Glycerin, 2% fl. ozs., in 16 fl. ozs. 



THE NATIONAL FORMULARY. 537 

Liquor — 

Iodi Caustic us. — (Iodine Caustic. Churchill's Iodine 

Caustic.) Iodine, 1 tr. oz. ; Iodide of Potassium, 2 tr. 

ozs., in Water, 4 fl. ozs. 
Magnksii Bromidi. — Each fluidounce contains about 7 

grains of Bromide of Magnesium. 
Morphine: Citratis. — Each fluidrachm contains 2 grains 

of Morphine in the form of citrate. 
Morphine Hypodermicus. — (Magendie's Solution of 

Morphine.) 16 grs. Morph. Sulph. to each fl. oz. (See 

note. 1 ) 
Pancreaticus. — (Pancreatic Solution.) Each fluidrachm 

represents 1 grain of Pancreatin (N. F.), effectually pre- 
served in glycerin and a little alcohol. 
Pepsixi Aromaticus. — Each fluidrachm represents 1 grain 

of Pepsin (N. F.). 
Phosphori. — (Thompson's Solution of Phosphorus.) Each 

fluidrachm contains about ? ' ? grain of Phosphorus, preserved 

in absolute alcohol and glycerin. 
Picis Alkalixis. — (Tar, Alkaline.) 
Potass^: Chlorate. — (Solution of Chlorinated Potassa — 

Javelle Water.) An effective and popular disinfectant. 
Potassii Arseniatis et Bromidi. — (Liquor Arsenii 

Bromidi — Clemens' Solution.) This Solution contains 

an amount of Arsenic in combination corresponding to 

about 1 per cent, of Arsenious Acid. 

The title " Solution of Bromide of Arsenic" (Liquor Arsenii 
Bromidi) which is often applied to Clemens' Solution or simi- 
lar preparations, is a misuouner, since bromide of arsenic eau- 
not exist, as such, in presence of water, but is split up into 
hydrobromic and arsenious acid. The proportions of the ingre- 
dients, in the formula above given, have been adjusted, as 
closely as practicable, so as to yield definite compounds, viz : 
arseniate and bromide of potassium. 

1 Particular care should be taken in prescribing and dispensing this 
solution, so that it may not be mistaken for the so-called United States 
Solution of Morphine (Liquor Morphia? Sulphatis, U. S. P. 1870), con- 
taining only 1 grain of Sulphate of Morphine in each fluidounce, which 
is still used in some parts of this countiw. 

The development of fungoid growths or micro-organisms in this and 
similar solutions used hypodermically may be prevented, or at least 
greatly retarded, by using Chloroform Water instead of plain Distilled 
Water as a solvent. This, however, to be done only with the knowl- 
edge, or by the direction, of the physician. 

Another efficient method to preserve such solutions is, to sprinkle a 
little Benzoic Acid on the surface of the absorbent cotton through 
which the solutions are filtered. Or, about 5 grains of Boric Acid 
mav be added to each fluidounce. 



538 THE NATIONAL FORMULARY. 

Liquor Saccharini. — (Solution of Saccharin.) Each 
fluidrachm represents 4 grains of Saccharin. 

Saccharin is "anhydro-ortho-sulphamine-benzoic acid," an artifici- 
ally prepared member of the so-called aromatic series of organic 
chemicals. It is a body having feebly acid properties, soluble in about 
333 parts of water and in 33 parts of alcohol at 15° C. (59° F.) . When 
neutralized by an alkali, it is quite soluble in water. 

The Solution of Saccharin is intended to be used for sweetening 
liquids and solids, when the use of sugar is objectionable, or when a 
sweet taste is to be imparted to a liquid without increasing its density. 

Liquor Seriparus. — (Liquid Rennet.) 

If this liquid is to be used merely for curdling milk, without sepa- 
rating the whey as a distinct layer, it should be added to the milk, 
previously warmed to a temperature of about 35° C. (95° F.), and 
the mixture should then be set aside undisturbed, until it coagulates. 
If the whey is to be separated, the Liquid Rennet should be added to 
the milk while cold, and the mixture heated to about 35° C. (95° F.), 
but not exceeding 40° C. (104° F.). One part of the liquid should 
coagulate between 200 and 300 parts of cow's milk. 

Liquor Sodii Arseniatts, Pearson. — This Solution con- 
tains about fa per cent, of anhydrous Arseniate of Sodium. 

This preparation should not be confounded with the Liquor Sodii 
Arseniatis of U. S. P., which is ten times stronger than the above. 
Pearson's Solution is officinal in the French Pharm., under the title 
Solute d' Arseniate de Soude (or Solution Arsenicale de Pearson). 

Liquor — 

Sodii Boratis Compositus. — (Dobell's Solution.) Borate 

of Sodium and Bicarbonate of Sodium, each 120 grs. ; 

Carbolic Acid, 24 grs.; Glycerin, ^ fl. oz., in Water, 16 

fl. ozs. 

Sodii Cakbolatis. — (Phenol Sodique.)— Carbolic Acid, 

50 per cent. ; Soda, 3 per cent., in Water. 
Sodii Citratis. — Saturatio (Potio Riveri, P. Ger.) — Citric 
Acid, 150 grs. ; Bicarbonate of Sodium, 190 grs., in Water, 
16 fl. ozs. 
Sodii Citro-Tartratis. — (Effervescing Saline- Water.) — 
Bicarbonate of Sodium, Tartaric Acid, Citric Acid, Syrup 
and Water, in about the same proportions as in Solution 
of Citrate of Magnesium, for which it is a cheaper sub- 
stitute. 
Sodii Oleatis. — (Oleate of Sodium.) Intended to be used 

in the preparation of oleates. 
Strychnine Acetatis. — (Hall's Solution of Strychnine.) 
Each fluidrachm contains £ gr. acetate of Strychnine. 
The P. B. directs a Liquor Strychninae Hydrochloratis (with syno- 
nym : Liquor Strychninae) which is much stronger, and should not be 
confounded with the above preparation. It should never be dispensed 
unless expressly designated. 



THE NATIONAL FORMULARY. 539 

Liquor — 

Zinci et Ferri Compositus. — (Deodorant Solution.) A 
combination of Sulphates of Zinc and of Iron, Naphthol, 
Oil of Thyme and Hypophosphorous Acid, in Water. 

Used as a simple deodorant and antiseptic for common 
domestic use, when it is unnecessary or impracticable to 
employ more powerful agents. 

When a deodorant solution is required for purposes where 
iron is objectionable, as, for instance, when woven fabrics 
are to be steeped in it, the following preparation may be 
employed : 

2. Liquor Zinci et Aluminii Compositus, in which the 
sulphate of iron is replaced by Sulphate of Aluminium. 
Zingiberis. — (Soluble Essence of Ginger.) A 25 per cent, 
preparation of Ginger for flavoring aqueous mixtures. 



MISTUR.E— MIXTURES. N. F. 

MlSTURA — 

Acacle. — (Mixtura Gummosa, P. Ger.) 

Acacia, pulv., Sugar, each 1 tr. oz., in Water, 12 fl. ozs. 
Should be freshly made when wanted for use. 

Adstringens et Escharotica. — (Villate's Solution.) 
Solution of Subacet. Lead, 1| fl. ozs. ; Sulphates of 
Copper, Zinc, each 1 tr. oz. ; Acetic Acid, 13 fl. ozs. 

Ammonii Chloridi. — (Mistura Solvens Simplex.) Chlo- 
ride of Ammonium, Purif. Ext. Glycyrrhiza, each 180 
grains, in Water, 16 fl. ozs. 

Mistura (or Mixtura) Solvens Stibiata is prepared by dis- 
solving 2 grs. Tartrate Antimony and Potassium in each 
pint of Mistura Ammonii Chloridi. 

Camphorj; Acida.. — (Mistura Antidysenterica — Hope's 
Mixture.) Nitric Acid, 120 mins. ; Tinct. Opium, 80 
mins. ; in Camphor Water, 16 fl. ozs. 

Camphors Aromatica. — (Parrish's Camphor Mixture.) 
Tinct. Lavender Comp., 4 fl. ozs. ; Sugar, 240 grs. ; in 
Camphor Water, 16 fl. ozs. 

Carminativa. — (Dalby's Carminative.) Carb. Magnes., 
1 tr. oz. ; Carb. Potass., 20 grs. ; Tinct. Opium, 180 
mins. ; Oils of Caraway, Fennel, Peppermint, each, 4 
drops; Syrup, 2j fl. ozs.; in 16 fl. ozs. Each fluid 
ounce represents about 1 grain of Opium. 

Chloral et Potassii Bromidi Composita. — (Mixture of 
Chloral and Bromide.) Each fluidrachm contains 15 grs. 
each of Chloral and Bromide Potassium, and §• gr. each 
of Exts. Indian Cannabis and Hyoscyamus. 



540 THE NATIONAL FORMULARY. 

Mistura Chlorofokmi et Opii — (Chloroform Anodyne.) 

Chloroform Purif. 2 fl. ozs. Tinct. Op., Deod. 22 fl. drs. 

Oil of Peppermint 16 mins. Tinct. Capsicum . 1 fl. oz. 

Tinct. Ind. Cannab. 2 fl. ozs. Glycyrrhiza, Purif. 240 grs. 

Tinct. Quillaja. . 2 fl. ozs. Water \ fl. oz. 

Fl. Ext. Bellad. . 128 mins. Syrup . . . to make 16 ozs. 

Each fluidrachm represents 7| mins. each of Chloroform and 
Tinct. Indian Cannabis; 3f mins. Tinct. Capsicum; 1 min. fl. 
Ext. Belladonna, and about 1 gr. Opium. 

This preparation is intended to fulfil the same purposes as the 
Tin dura Chloroformi et Morphince P. Br., though the composi- 
tion of the latter differs materially from the above. 

Mistura Contra Diarrhceam — (I. Cholera Mixture.) 

Tinctures of Opium, Capsicum, Rhubarb and Spirit of Cam- 
phor and Peppermint, each, equal volumes. 

The above formula appears to be that in most general use, also 
known under the name of " Sun Mixture." 

Of other similar preparations, in more or less general use, the 
following may be mentioned here : 

2. Loomis' Diarrhoea Mixture. 
Tincture Opium . ^ fl. oz. Tinct. Catechu Comp. ^ fl. oz. 
Tincture Rhubarb . £ fl. oz. Oil of Sassafras . . 20 mins. 
Tincture Lavender Comp to make 4 fl. ozs. 

3. Squibb's Diarrhcea Mixture. 
Tincture Opium . 1 fl. oz. Spirit of Camphor . 1 fl. oz. 
Tincture Capsicum 1 fl. oz. Purif. Chloroform 180 mins. 
Alcohol enough to make 5 fl. ozs. 

4. Thielemann's Mixture — (Mixt. Thielemanni, P. Suec.) 
Wine Opium 1 fl. oz. Oil Peppermint . . 60 mins. 

Tinct. Valerian . 1^ fl. oz. Fl. Ext. Ipecac . . 15 mins. 
Ether .... £ fl. oz. Alcohol, to make . 4 fl. ozs. 

5. Velpeau's Diarrhcea Mixture. 
Tincture Opium, Tincture Catechu Comp., Spirit Camphor, of 
each, equal volumes. 

Mistura Copaib^e Composita. 

1. Lafayette Mixture. 

Copaiba . . . . 2 fl. ozs. Spirit Nitr. Ether . 2 fl. ozs. 

Tinct. Lavan. Comp. 2 fl. ozs. Syrup . . . . 5 fl. ozs. 

Solution Potassa . £ fl. ozs. Mucilage Dextrin to 16 fl. ozs. 

This mixture should be well agitated when used. 

Each fluidrachm contains 7^ minims of Copaiba. 



THE NATIONAL FORMULARY. 541 

2. Chapman's Mixture. 
Copaiba . . . ]£ fl. ozs. Spirit Nitros Ether 1^ fl. ozs. 
Tinct. Lav. Comp. 136 mins. Acacia, Sugar, each 180 grs. 
Tincture Opium . 180 rains. Water, to make 16 fl. ozs. 

Mistura Expectorans, Stokes — (Stokes' Expectorant.) 

Ammonium Carb. . 128 grs. Tinct. Opii Camph. 3 fl. ozs. 
Fl. Ext. Senega . £ fl. oz. Water . . . . 1£ fl. ozs. 
Fl. Ext. Squill . . £ fl. oz. Syrup Tolu, to make 16 fl. ozs. 

Mistura — 

Guaiaci — (Guaiac Mixture, P. Br.) Resin Guaiac, Sugar, 

each, 190 grs. ; Acacia, powder, 100 grs. ; Cinnamon 

Water, 16 fl. ozs. To be well agitated when used. 
Oleo-Balsamica. — (Balsamum Vita? Hotfmanni, P. Ger.) 

A solution of Oils of Lavender, Thyme, Lemon, Mace, 

Orange Flowers, Cloves, Cinnamon and Balsam Peru in 

Alcohol. 
Olei Picis. — (Tar Mixture.) A mixture of Oil of Tar, 

£ fl. oz. ; Chloroform, 75 mins. ; Oil of Peppermint, 20 

mins., in Elixir, to make 16 fl. ozs. 
Rhei Composita. — (Squibb's Rhubarb Mixture.) Fl. Ext. 

Rhubarb, 1 28 mins. ; Fl. Ext. Ipecac, 25 mins. ; Sodium 

Bicarb., 256 mins. ; Glycerin, 6 fl. ozs., in Peppermint 

Water, 16 fl. ozs. 
Sassafras et Opii — (Mist. Alkalina— Godfrey's Cordial.) 

A mixture of Oil of Sassafras, Tincture of Opium, and 

Potass. Carb. in Molasses, Alcohol and Water. 
Each fluidrachm contains 2 mins. Tinct. Opium, corresp. to ^ 

gr. Opium. 
Sod,e et Mentha. — (Soda Mint.) Sodium Bicarb., 320 

grs. ; Spirit Ammonia, 60 mins. ; Spearmint Water, 16 

fl. ozs. 
Splenetica. — (Spleen Mixture. — Gadberry's Mixture.) 
* Sulphate Iron, Sulphate Quinine, Nitric Acid, each, 100 

grs.; Nitrate of Potassium, 300 grs. in Water, 16 fl. ozs. 
Sulphurica Acida. — (Haller's Acid Elixir, P. Ger.) 

Sulphuric Acid, 1 part, Alcohol to make 4 parts. 



Oxymel Scillae. — (Oxymel of Squill, P. Br.) A preparation 
of Honey containing about 5 grains of Squill in each fluidrachm. 

46 



542 THE NATIONAL FORMULARY. 



OLEATA— OLEATES, N. F. 

The following are simply solutions of the alkaloids in Oleic 
Acid : 

Oleatum Aconitinje — Containing 2 per cent, of crystallized 
Aconitine (Duquesnel's). 

Oleatum Quinine— Containing 25 per cent, of Quinine (Alka- 
loid). 

Of the Oleates introduced by Dr. J. V. Shoemaker the follow- 
ing have been recognized, but others may also be prepared as de- 
sired : 
Oleatum Plumbi — Containing about 28 per cent, of Oxide of 

Lead. It is of the consistence and general character of 

Lead Plaster, and suggests similar use. 
Oleatum Zinci. — In the form of a soft, white powder, useful as 

a " dusting powder," or converted into a plaster or ointment 

by mixing it with such proportion of Oleic Acid as may be 

required. 



OLEA— OILS. N. F. 

Olea Infusa — Infused Oils. 

These preparations are obtained by infusing a dry herb, usually 
from the so-called narcotic plants, in five times its weight of a 
mixture of equal parts of cottonseed and lard oil. Oleum Hyos- 
cyami Infusum is the most familiar example. 
Oleum Carbolatum. — A mixture of Cottonseed Oil with 5 per 

cent, of Carbolic Acid. 
Oleum Hyoscyami Compositum. — (Balsamum Tranquillans.) 

Infused Oil of Hyoscyamus, with a small proportion of each 

of the Ethereal Oils of absinth, lavender, rose, sage and 

thyme. 



EMPL ASTRA— PLASTERS. N. F. 

In rolls, to be spread any size, according to prescription, upon 
leather. 

Emplastrum Aromaticum (Spice Plaster)— Consisting of 
Cloves, Cinnamon and Ginger, each 10 per cent. ; Capsicum 
and Camphor, each 5 per cent. 

Emplastrum Fuscum Camphoratum (E. Matris Camphoratum, 
Ph. Ger. — Camphorated Mother's Plaster). A plaster simi- 
lar to lead plaster, and containing camphor 1 per cent. 



THE NATIONAL FORMULARY. 543 

Emplastrum Picis Liquid.*; Comp. — A mixture of Resin and 
Tar, with Podophyllum, Phytolacca and Sanguinaria, of 
each, 8 per cent. 



PEPTONIZING AGENTS. N. F. 

Pancrkatinum. — (Pancreatin.) 

Prepared from the fresh Pancreas of the hog. 

Five grains, tested by the method given under Pulvis Pancreaticus 
Comp., so completely peptonizes 1 pint Milk that, on adding to a small 
portion of it, transferred to a test-tube, a slight excess of nitric acid, 
coagulation should not occur. 

As peptonized milk is chiefly used as a food for the sick, and as Pan- 
creatin is probably more largely employed for the practical purpose of 
peptonizing milk, it is imporant to observe the quality of the pepton- 
ized product yielded with any specimen of Pancreatin. Peptonized 
milk, as prepared by the above process, or when the process is allowed 
to go on to the development of a very distinct bitter flavor, should not 
have an odor at all suggestive of rancidity. Milk has simply a marked 
bitter taste when thoroughly peptonized. 

Pepsinum. — (Pepsin.) 

The digestive principle of the gastric juice, obtained from the 
mucous membrane of the stomach of the hog, prepared in a dry 
and undiluted form, and capable of dissolving not less than Jive 
hundred (500) times its own weight of hard-boiled egg-albu- 
men, under the conditions prescribed for the process of assay of 
the N. F. 
Pepsinum Aromaticum. — (Aromatic Pepsin.) 

Saccharated Pepsin, with Aromatic Fluid Extract and the ad- 
dition of a little Tartaric Acid and Chloride of Sodium. 
Pepsinum Saccharatum. — (Saccharated Pepsin.) 

Corresponds, in strength, to that of the U. S. P. 
Pulvis Pancreaticus Compositus. — (Peptonizing Powder.) 

Pancreatin (N. F.) 5 grains. 

Bicarbonate of Sodium 20 " 

The above mixture is sufficient to peptonize 1 pint of fresh cow's 
milk, by proceeding in the following manner : 

Add the Compound Pancreatic Powder to 4 fluid ounces of tepid 
Water, contained in a suitable flask, and afterwards add 1 pint of fresh 
cow's Milk, previously heated to 38° C. (100.4° F.). Maintain the 
mixture at this temperature thirty minutes, then transfer to a cold 
place. 

Milk thus peptonized should not be used when it has been kept over 
twenty-four hours or when it has developed a bitter taste. 
Pulvis Pepsini Compositus. — (Pulvis Digestivus.) 

Saccharated Pepsin, 15. ; Pancreatin, 15. ; Diatase, 1. ; Lac- 
tic Acid, 1. ; Hydrochloric Acid, 2., in Sugar of Milk, 100. 

This preparation is intended to replace a proprietary article sold 
at a fancy price. 



544 THE NATIONAL FORMULARY. 

Succus LiMONis cum Pepsino. — (Each fluidrachm contains 2 

grs. of pepsin, N. F.) 
Vinum Pepsini. — (Each teaspoonful contains 1 grain of pepsin, 

N. F.) 



PILULE— PILLS. N. F. 

In stating the quantities of the several ingredients for each single 
pill, in the formulae hereinafter given, it was often necessary 
to choose the nearest simple fraction approximating the true 
value. When a large number of pills is to be prepared in accord- 
ance with the given proportions, and the quantities of the ingre- 
dients are to be determined by multiplying with the number of 
pills required, it is recommended that the nearest whole number, 
or nearest convenient fraction, in each case, be chosen. 
Pilule ad Pkandium. — (Dinner Pills.) 

When ' ' Dinner Pills, ' ' under this or some other equivalent name, 
are prescribed without further specification, the National Formu- 
lary recommends that the Pilulae Aloes et Mastiches of the U. S. P., 
also called Lady Webster's Dinner Pills, be dispensed. 

Of other combinations, bearing similar names, or used for similar 
purposes, the following appears to be those most commonly in use : 





Chapman's Dinner Pill. 




Aloes 

Mastic .... 


. gr. 1^- Ipecac .... 
. gr. 1£ Oil of Fennel . . 

Cole's Dinner Pill. 


. gr. 1 
i 


Aloes 

Mass of Mercury 


. gr. l£ Tar. Ant. and Potas. 
. gr. l\ Jalap 

Hall's Dinner Pill. 


g r - A 
gr- 1§ 


Aloes .... 
Ext. of Glycyrrhiza 


. . gr. 1 Soap, in powder . . 
. gr. 1 Molasses .... 


. gr. 1 
. gr. 1 


Pil. Aloes et Podophylli Composite. — (Janeway' 


3 Pills.) 


Aloes 

Resin Podophyllum 


. gr. 1 Ext. Bellad. Ale. 
. gr. ^ Ext. Nux Vomica . 


• g r - i 

• gr- i 



Pil. Aloini Composite. 

Aloin gr. i Extract of Belladonna gr. \ 

Resin Podophyllum . . gr. | 

Pil. Aloini, Strychnine et Belladonna. 

Aloin gr. 5 Alcoholic Extract of 

Strychnine, alkaloid . gr. t }q Belladonna . . . . gr. £ 



THE NATIONAL FORMULARY. 545 



Pil. Aloini, Strychnine et Belladoxne Composite. 

Aloin gr. £ Strychnine, alkaloid, gr. T ^ ff 

Ext. Bellad. Ale. . . gr. I Ext. Rham. Pursh., gr. £ 

Pil. Antidyspeptice. 

Strychnine, alkaloid . gr. -fa Mass of Mercury . . . gr. 2 

Ipecac gr. ^ Compound Extract of 

Ext. Bella. Ale. . . gr. T x Colocynth . . . . gr. 2 

Pil. Antineuralgice. 

1. Gross's Antineuralgic Pills. 

Sulphate of Quinine . gr. 2 Arsenious Acid . gr. /g- 

Sulphate of Morphine gr. ^ Ex. Aconite Leaves (U. 
Strychnine, alkaloid . gr. ^ S. P. 1870) . . . gr. ± 

When "Antineuralgic Pills," or "Neuralgia Pills," without 
other specifications, are prescribed, it is recommended that the 
above preparation be dispensed. Sometimes the Sulphate of 
Morphine is directed to be omitted when it is so ordered. 

2. Broivn-Sequard' s Antineuralgic (or Neuralgia) Pills. 

Extracts of Hyoscyamus and Conium, each gr. § 

Extracts of Ignatia and Opium, each gr. i 

Ext. Aconite Leaves . gr. ^ Ext. Indian Cannabis . gr. ^ 

Ext. Stramonium . . gr. £ Ext. Bellad. Ale. . . gr. ^ 

Pil. Antiperiodice. — (Warburg's Pills.) 

1. With Aloes: 

Aqueous Extract of Aloes gr. 1 

Rhubarb gr. J- 

Elecampane, Saffron, Fennel, each gr. ^ 

Zedoary, Cubebs, Myrrh, White Agaric, Camphor, each gr. §• 

Sulphate of Quinine gr. 1 1 

Extract of Gentian a sufficient quantity. 

2. Without Aloes: The same formula as above, with the omis- 
sion of the Aqueous Extract of Aloes. These pills have been 
introduced for the purpose of facilitating the administration of 
Warburg's Tincture in a solid form. When "Warburg's Pills," 
or " Pills of Warburg's Tincture" are prescribed, without further 
specification, those containing Aloes are recommended to be dis- 
pensed. Those without Aloes only when they are expressly 
demanded. 

Each Warburg's Pill represents about 1 fluidrachm of War- 
burg's Tincture (see Tinctura Antiperiodica). 

46* 



546 THE NATIONAL FORMULARY. 

Pil. Cathartics Vegf.tabiles. — (Imp. Vegetable Cathartic.) 

Compound Extract of Colocynth gr. 1 

Resin of Podophyllum, Ext. Leptandra, each . . . gr. \ 

Abstract Jalap, Exts. Hyoscyamus and Gentian, each . gr. £ 

Oil of Peppermint min. ^ 

Extract of Leptandra (U. S. P.) is preferable to the so-called 
Leptandrin, or Resin of Leptandra, as this is of very uncertain 
and varying composition. 

Pil. Colocynthidis Composite. — (Pilulas Cochia.) 

Extract of Colocynth gr. ^ 

Aloes, Resin of Scammony, each gr. 2 

Oil of Cloves min. \ 



tV 



Pil. Colocynthidis et Hyoscyami. 

Extract of Colocynth gr. 

Aloes, Resin of Scammony, Ext. Hyoscyamus, each . gr. 1^ 
Oil of Cloves min. ^ 

Pil. Colocynthidis et Podophylli. 

Compound Extract of Colocynth grs. 2^- 

Resin of Podophyllum gr. { 

Pil. Ferki Carbonatis. — (Ferruginous — Blaud's Pills.) 

Sulphate of Iron, in clear crystals grs. 240 

Carbonate of Potassium grs. 140 

Sugar grs. 48 

Tragacanth, in fine powder grs. 16 

Glycerin mins. 10 

Water a sufficient quantity. 

Make a mass according to the directions in the National Formu- 
lary, and divide into ninety-six (96) pills. 

Each pill represents about 1 grain of ferrous carbonate. 

"Three-grain" Blaud's Pills (Pilulae Blaudii minores) when 
prescribed are recommended to be prepared by dividing the above 
mass into one hundred and sixty-eight (168) pills. 

Pil. Glonoini. — (Nitroglycerin.) 

Spirit of Glonoin (N. F., 1 per cent.) grs. 200 

Althaea, in fine powder grs. 198 

Confection of Rose a sufficient quantity. 

Make a mass (according to N. F.) and divide it into two 
hundred (200) pills. 

Each pill contains t £q grain of Glonoin (Nitroglycerin). 



THE NATIONAL FORMULARY. 547 



Pil. Laxative Post Partum. — (Barker's.) 

Compound Extract of Colocynth grs. If 

Aloes gr. f Res. Podoph., Ipec., ea. gr. T ^- 

Ext. Nux Vomica . gr. T \ Ext. Hyoscyamus . gr. 1^ 

This is the formula generally employed by Dr. Fordyce Barker, 
except where special circumstances render modifications necessary. 
The formula usually quoted in manufacturers' lists and some formu- 
laries is not correct. 

Pil. Metallorum. — (Metallorum Amaras.) 

Reduced Iron and Sulphate of Quinine, of each . . . gr. 1 
Strychnine and Arsenious Acid, of each gr. ■£§ 

Aitken's Tonic Pill is a similar combination : 
Reduced Iron . . gr. § Strychnine, Arsenious 

Sulphate of Quinine gr. 1 Acid, each . . . gr. 

Pil. Opii et Camphors. 

Powdered Opium . gr. 1 Camphor .... grs. 2 

Pil. Opii et Plumbi. 

Powdered Opium and Acetate of Lead, of each . . . gr. 1 

Pil. Podophylli, Belladonna et Capsici. — (Squibb's 
Podophyllum Pills.) 

Resin Podophyllum gr. ^ Capsicum . . . . gr. £ 

Ext. Bellad. Ale. . gr. ^ Sugar of Milk . . gr. 1 

Acacia, Glycerin and Syrup, each ... a sufficient quantity. 

Pil. Quatuor. — (Ferri et Quininae Compositae.) 

Sulphate of Iron, Sulphate of Quinine, Aloes, each . gr. 1 
Ext. Nux Vomica . gr. \ Ext. Gentian . sufficient. 

Pil. Triplices. — (Triplex.) 

Aloes grs. 2 Resin Podophyllum gr. \ 

Mass of Mercury . gr. 1 

When Pilula Triplex, under this name or some equivalent, is 
presented without further specification, the N. F. recommends 
that the above preparation be dispensed. A formula devised by 
Dr. John W. Francis is also in use: 

Francis's Triplex Pill. 
Aloes, Scammony, Mass of Mercury, of each . . . . gr. £ 
Croton Oil . . . min. ^ Oil of Caraway . . gr. \ 
Tinctures of Aloes and Myrrh ... a sufficient quantity. 



548 THE NATIONAL FORMULARY. 

PULVERES— POWDERS. N. F. 

PULVIS— 

Acaci^e Compositus. — (Pulvis Gummosus, P. Ger.) 

Aloes et Canell^e. — (Hiera Picra.) 

Amygdalae Compositus. — (Almonds Comp.) A mixture 

of Sweet Almond, Sugar and Acacia, in fine powder. 

820- grs. triturated with Water, yields about 16 fluidounces 

of Mistura Amygdalae. 

Anticatarrhalis. — (Catarrh Snuff.) Hydrochlorate of 
Morphine, 1 part ; Acacia, 60 parts, and Subnitrate of 
Bismuth, 180 parts, in fine powder. 

Catechu Compositus. — (Compound Powder of Catechu, 
P. Br.) Catechu, 4 parts; Kino, 2 parts; Krameria, 2 
parts ; Cinnamon, 1 part, and Nutmeg, 1 part. 

Cret^: Aromaticus. — A mixture of Cinnamon, Saffron, 
Nutmeg, Cloves, Cardamom, prepared Chalk and Sugar. 

Cret^e Aromaticus cum Opio. — Aromatic Powder of 
Chalk, with 1 grain of powdered Opium, in 40 grains of 
the mixture. Officinal in the Brit. Pharm. 

Hydrargyri Chloridi Mitis et Jalap^e. — (Calomel 
and Jalap.) A mixture of Mild Chloride of Mercury, 10 
grains, and Jalap, 20 grains. 

When "Calomel and Jalap" is prescribed for an adult, 
without any specification of quantities, the N. F. recom- 
mends that the above mixture be dispensed as one dose. 

Iodoformi Dilutus. — (Iodoform and Naphthalin.) A 
mixture of Iodoform, 2 parts ; Boric Acid, 3 parts ; Naph- 
thalin, 5 parts, with Oil of Bergamot, in fine powder. 

This powder is used in many cases where a diluted prepa- 
ration of Iodoform, for external purposes, is desired. The 
odor is masked both by the Oil of Bergamot and by the 
Naphthalin. 

Kino Compositus. — A mixture of Kino and Cinnamon, 
with 1 grain of Powdered Opium in each 20 grains. 

Myrcle Compositus. — (Composition Powder.) A mix- 
ture of Bay berry, Ginger, Capsicum and Cloves. 

Rhei et Magnesia Antsatus. — (Compound Anise Pow- 
der.) A mixture of Rhubarb, Heavy Magnesia and Oil 
of Anise. 

Talci Salicylicus. — (Salicylated Powder of Talcum.) 
A mixture of Talcum, with 3 per cent. Salicylic Acid and 
10 per cent. Boric Acid, in line powder. 



THE NATIONAL FORMULARY. 549 

SALTS— EFFERVESCENT (Granular). N. F. 

Ninety grains represent about the quantity of these Salts contained 
in a heaped teaspoonful of ordinary size. 

Caffeine Citras Effervescens. 

Ninety grains represent 1 grain Caffeine. 
Ferri et Quinine Citras Effervescens. 

Ninety grains represent 1 grain Citrate of Iron and Qui- 
nine. 
Ferri Fhosphas Effervescens. 

Ninety grains represent 2 grains Phosphate of Iron. 
Potassii Bromidum Effervescens. 

Ninety grains represent 20 grains Bromide of Potassium. 
Potassii Bromidum cum Caffein.e. 

Ninety grains represent 10 grains Bromide of Potassium and 
1 grain Caffeine. 
Potassii Citras Effervescens. 

Ninety grains represent 10 grains Citrate of Potassium. 
Sal Carolinum Factitium Effervescens — (Effervescent 

Carlsbad Salt, artificial). — A solution of about 87 grains in 6 

fl. ozs. of Water represents an equal volume of Carlsbad 

Water (Sprudel). 
Sal Kissing ense Factitium Effervescens — (Effervescent 

Kissingen Salt, artific). — A solution of about 80 grains in 6 

fl. ozs. represents an equal volume of Kissingen Water 

(Rakoczy). 
Sal Vichyanum Factitium Effervescens — (Effervescent 

Vichy Salt, artific). — A solution of about 57 grains in 6 fl. 

ozs. of Water represents an equal volume of Vichy Water 

(Grand Grille). 



SALTS— NON-EFFERVESCENT (for Making the 
Above). N. F. 

Sal Carolinum Factitium. — In two forms : Dry (Pharm. 

Ger.) and Crystalline. A solution of about 16 grains of the 

Dry (20 of the Crystalline) in 6 fl. ozs. of Water represents 

an equal volume of Carlsbad Water (Sprudel). 
Sal Kissingense Factitium. — A solution of about 24 grains 

in 6 fl. ozs. of Water represents an equal volume of Kissen- 

gen AVater (Rakoczy). 
Sal Vichyanum Factitium. — A solution of about 14 grains 

in 7 fl. ozs. of Water represents an equal volume of Vichy 

Water (Grand Grille). 



550 THE NATIONAL FORMULARY. 

SPIRITUS-SPIRITS. N. F. 
Spiritus — 

Acidi Formici.— (Spirit of Ants, P. Ger.) A solution of 

3 per cent, of Formic Acid, in Water and Alcohol. 
Amygdalae Amar^:. — (Bitter Almond Essence.) 
Aromaticus. — (Aromatic Spirit.) 
Aurantii Compositus. — (Orange Compound.) 
Cardamomi Compositus. — (Cardamom Compound.) 
Curassao. — (Spirit of Curacao.) For Elixir Curacao. 
Glonoini. — (Solution of Nitroglycerin.) A solution of 
Glonoin (or Nitroglycerin) in officinal Alcohol, containing 
one (1) per cent., by weight, of the former. 

Glonoin (or Nitroglycerin), for medicinal purposes, is usu- 
ally procured in the form of a 10 per cent, solution in alcohol. 
Such a solution is non-explosive, and may be diluted, as occa- 
sion requires, to the strength of I per cent. The specific gravity 
of the 10 per cent, solution is 0.863 at 15° C. (59° F.). 

Solutions of Glonoin, particularly the stronger (10 per cent.), 
should always be transported or kept in tin cans, and never in 
glass or other fragile vessels. Should the container of a Solu- 
tion of Glonoin be broken, and the contents be soaked up by 
wood, or packing material, the latter may become dangerously 
explosive when the alcohol has evaporated. 

When handling an alcoholic solution of Glonoin, care should 
be taken that it be not brought in prolonged or extended con- 
tact with the skin, as it is readily absorbed, and will then 
cause its characteristic physiological effects (distressing head- 
ache, nausea, etc.). 

Olei Volatilis. — (A General Formula.) 400 min. of any 
volatile oil, Alcohol, deod., to make 16 fl. ozs. 

Ophthalmicus. — (Alcoholic Eye- Wash.) A solution of 10 
mins. Oil of Lavender and 30 mins. Oil of Rosemary, in 
Alcohol, 1 fluid ounce. 

Phosphori. — (Tincture of Phosphorus.) Each fluidrachm 
contains T \ grain of Phosphorus ; or, 14.4 minims contain 
■50 g ram °f Phosphorus. 

This preparation is intended for preparing the Elixir of Phos- 
phorus (see No. 85). It is unsuited for internal administration 
without corrigents. Care should be taken that it be not con- 
founded with Thompson's Solution of Phosphorus (see Liquor 
Phosphori). 

Saponatus. — (Spirit of Soap.) 

Sinapis. — (Spirit of Mustard, P. Ger ) A solution of 2^ 
per cent, of Volatile Oil of Mustard in Alcohol. 



THE NATIONAL FORMULARY. 551 

SYRUPI— SYRUPS. N. F. 
Syrupus — 

Acidi Hydriodici Decolor. — Containing 1 per cent, or 
about 1 min. of Hydriodie Acid to the fluidrachm. 

Act.e^e Compositus. — (Cimicifuga or Black Cohosh.) Con- 
taining 2^- grains each of Cimicifuga and Wild Cherry, 1^ 
grains Glycyrrhiza and Senega, and f grain Ipecac in each 
fluidrachm. 

Asari Compositus. — (Canada Snake Root.) Each flui- 
drachm represents 3j? grains of Asarum. 

Calcii Chlorhydrophosphatis. — (Chlorhydrophosphate 
of Lime.) Each fluidrachm contains 1 grain of Phosphate 
of Calcium. 

Calcii et Sodii Hypophosphitum. — (Hypophosphite of 
Lime and Soda.) Each fluidrachm contains 2 grains, each, 
of Hypophosphites of Calcium and of Sodium. 

Calcii Hypophosphitis. — (Hypophosphite of Lime.) Each 
fluidrachm contains 2 grains of Hypophosphite of Calcium. 

Calcii Iodidi. — (Iodide of Calcium.) Each fluidrachm 
contains about 5 grains of Iodide of Calcium. 

Calcii Lactophosphatis cum Ferro. — (Lactophosphate 
of Lime with Iron.) Each fluidrachm contains §- grain of 
Lactate of Iron and about | grain of Lactate of Calcium 
(or about f grain of so-called Lactophosphate of Calcium). 

Chondri Compositus. — (Irish Moss.) Containing 1 grain 
each of Squill and Senega, .y 1 ^ grain each of Ipecac and 
Irish Moss and If mins. Tincture Opium Camph. to each 
fluidrachm. 

Cinxamomi. — (Cinnamon, P. Ger.) Chiefly used for flavor- 
ing. 

Coffe^e. — (Coffee.) Containing 15 grains of the choicest 
Coffee (Java and Mocha) in one fluidrachm, an elegant 
vehicle for Quinine and addition to nauseous mixtures. 

Eriodictyi Aromaticus. — (Yerba Santa — Syrupus Cor- 
rigens.) Chiefly intended as a vehicle for disguising the 
taste of Quinine and other bitter substances. 

Ferri Arseniatis.— Each fluidrachm contains about ^ 
grain of Arseniate of Iron (ferric). 

Ferri Citro-Iodidi.— (Tasteless Syrup of Iodide of Iron.) 
Each fluidrachm contains an amount of Iron corresponding 
to about 3.6 grains of Ferric Iodide. The officinal Syrupus 
Ferri Iodidi contains about 8 grains of ferrous iodide (prot- 
iodide of iron) in each fluidrachm. 



552 THE NATIONAL FORMULARY. 

Syrupus — 

Ferri et Mangani Iodidi. — (Iodide of Iron and Manga- 
nese.) Each fluidrachm contains 6 grains of Iodide of Iron 
(ferrous) and 3 grains of Iodide of Manganese. 

Ferri Hypophosphitis. — (Hypophosphite of Iron.) Each 
fluidrachm contains gr. 1 of Hypophosphite of Iron (ferric). 

Ferri Lactophosphatis. — (Lactophosphate of Iron.) 
Each fluidrachm contains 1 grain of Lactate of Iron, or 
about 1£ grains of so-called Lactophosphate of Iron. 

Ferri Protochloridi. — (Ferrous Chloride.) Each flui- 
drachm contains about 1 grain of Protochloride of Iron. 

Ferri Saccharati Solubilis. — (Soluble Saccharated 
Iron — Saccharated Oxide of Iron, P. Ger.) One hun- 
dred grains, or about 75 minims, represent approximately 

1 grain of metallic Iron, or 3 grains of Oxide of Iron. 
Glycyrrhiz^e. — (Licorice.) Each fluidrachm represents 

15 grains of Glycyrrhiza. 
Hypophosphitum Compositus. — Each fluidrachm contains 

2 grains of Hypophosphite of Calcium; 1 grain, each, of 
the Hypophosphites of Potassium and Sodium ; ^ grain, 
each, of the Hypophosphites of Iron and of Manganese ; 
T ' ff grain of Hydrochlorate of Quinine and 1| minims of 
Tincture of Nux Vomica. 

This Syrup should not be confounded with the officinal 
Syrupus Hypophosphitum (Syrup of the Hypophosphites ; 
Calcium, Sodium and Potassium). It is intended to re- 
place a well-known proprietary article for which it has 
been found by many physicians a satisfactory substitute. 
It is uniform in composition, and more stable and elegant 
than the patent article. 

Ipecacuanha et Opii. — (Syrup of Dover's Powder.) 
Each fluidrachm represents 5 grains of Dover's Powder, 
or £ grain, each, of Ipecac and Opium. 

Mannj:. — (Syrup of Manna, P. Ger.) 

Morphine Compositus. — A preparation sometimes dis- 
pensed as Jackson's Pectoral Syrup, but as differing in 
essential particulars, the N. F. recommends that this 
preparation be dispensed only when expressly designated 
under this title. Each fluidrachm contains ^ grain Ipecac, 
5 grains Senega, 1 grain Rhubarb and ^ grain Morphine 
with Oil of Sassafras. 

Morphine Sulphatis. — (Syrup of Morphine.) Each flui- 
drachm contains ^ grain of Sulphate of Morphine. 

This preparation is in considerable use in the Southern 
States. It should, however, never be dispensed unless it is 
known to be the preparation intended, or designated as that 
of the National Formulary (N. F.). 



THE NATIONAL FORMULARY. 553 

Syrupus — 

Papaveris (Poppy, P. Br. — Diacodii, P. Ger.) is similar 
to the preceding, but considerably weaker. 

Pectoralis. — (Jackson's Pectoral Syrup.) Each flui- 
drachm contains ^ grain, each, of Morphine and Oil of 
Sassafras. 

Phosphatum Compositus. — (Chemical Food.) Each flui- 
drachm contains about 2 grains of Phosphate of Calcium, 1 
grain, each, of the Phosphates of Iron and of Ammonium, 
and smaller quantities of the Phosphates of Potassium and 
Sodium. 

Rhamxi Cathartioje. — (Buckthorn Berries — Syrupus Spi- 
na? Cervinae, P. Ger.) 

Rubi Aromaticus. — (Blackberry Aromatic.) A combina- 
tion of Rubus, Cinnamon, Nutmeg, Cloves and Allspice. 

Sanguinari^e. — (Bloodroot.) Each fiuidrachm represents 
nearly 13 grains of Sanguinaria. 

Senx.e Aromaticus. — (Senna Aromatic.) Each fiuidrachm 
represents about 7^- grains of Senna, 3 grains of Jalap and 
1 grain of Rhubarb, with aromatics. 

Senjnle Compositus. — (Senna Compound.) Each fiui- 
drachm represents 8 grains of Senna, 2 grains of Rhubarb 
and 2 grains of Frangula. 

Sodii Hypophosphitis. — Each fiuidrachm contains 2 grains 
of Hypophosphite of Sodium. 

Stillingi^e Compositus. — Each fiuidrachm represents 15 
minims of Compound Fluid Extract of Stillingia. 



TINCTURE— TINCTURES. 

TlXCTURA — 

Aconiti Fleming. — Each fiuidrachm represents 40 grains 
Aconite, being about twice the strength of the officinal 
Tincture of Aconite. Dose, from 1 to 5 minims. 

The N. F. recommends that it be discarded for the Fluid 
Extract (which is stronger in the proportion of 15 to 10). 

Amara. — (Bitter Tincture, P. Ger.) Containing 3 grains, 
each, of Gentian and Centaury ; Bitter Orange Peel, 2 
grains ; Orange Berries and Zedoary, each, 1 grain. 

Ant AC rid a. — (Dysmenorrhea Mixture — Fenner's Guaiac 
Mixture.) A mixture of Guaiac, Canada Turpentine, Oil 
of Sassafras, and | grain Corrosive Chloride of Mercury in 
each fiuidrachm. Dose, from 10 to 20 minims. 

Antiperiodica. — (Warburg's Tincture.) With Aloes — 
Rhubarb, Angelica seed, of each, grains, 56 ; EJecam- 
47 



554 THE NATIONAL FORMULARY. 

TlNCTURA — 

pane, Saffron, Fennel, of each, grains 28 ; Aloes (aq. 
ext.), Gentian, Zedoary, Cubeb, Myrrh, White Agaric, 
Camphor, of each, grains 14; Sulphate of Quinine, 
grains 160; Diluted Alcohol, enough to make fl. ozs., 16. 

Antiperiodica. — (Warburg's.) The preceding without 
Aloes. Each fluid ounce of either tincture contains 10 
grains of Sulphate of Quinine. 

Aromatica. — (Stomachic, P. Ger.) A combination of Cin- 
namon, Ginger, Galangal, Cloves and Cardamom. 

Capsici et Myrrhs. — (Hot Drops.) The preparation 
popularly known as " Number Six." 

Cinchona Detannat^e. — For admixture with prepara- 
tions containing Iron. It represents about 10 grains of 
the active principles of Cinchona Calisaya, in their natural 
combinations, in each fluidrachm. 

Coto. — This preparation contains 7^ grains true Bolivian 
Bark in each fluidrachm. The Para-Coto, frequently em- 
ployed, differs considerably from the above. 

Ferri Chloridi ^Etherea. — (Bestucheff's Tincture — 
Lamott's Drops, P. Ger.) Each fluidrachm represents 
about £ grain of Metallic Iron. 

Ferri Pomata. — (Ferrated Extract of Apples — Malate of 
Iron, P. Ger.) Each fluidrachm represents about § grain 
of Metallic Iron. 

Ferri Citro-Chloridi. — (Tasteless Tincture of Iron.) 
Practically identical in the strength of Iron, but not Alco- 
hol, with the officinal Tincture Chloride of Iron, containing 
an amount of Iron equivalent to 7^ grains of Dry Chloride 
of Iron in each fluidrachm. 

A convenient form of Iron for admixture with Tincture 
of vegetable astringent drugs, such as Gentian and Cin- 
chona, preparations of which, unlike other iron compounds, 
it does not discolor. 

Guaiaci Composita. — (Dewees's Tincture of Guaiac.) 
Each fluidrachm represents 7j grains Guaiac. 

Iodi, Churchill. A solution of 10 grains Iodine in each 
fluidrachm, with Iodide of Potassium in Alcohol. . 

Not to be confounded with Churchill's Iodine Caustic 
(Liquor Iodi Causticus). 

Iodi Decolorata. — (Colorless Tincture Iodine.) The most 
approved formula for this well-known preparation. 

Jalap^e. — (U. S. P., 1870.) Each fluidrachm represents 
about 10 grains Jalap. 



THE NATIONAL FORMULARY. 555 

TlNCTURA — 

Jalaps Composita. — Each fkridrachm represents 7^ grains 

Jalap, and about two grains Scammony. 
Kino Composita — 

Tinctures Kino, Opium, each mins. 180 

Spirit of Camphor . . mins. 130 

Oil Cloves mins. 2£ 

Aromatic Spirit of Ammonia mins. 15 

Cochineal grs. 16 

Diluted Alcohol to make fl. ozs. 4 

Each fluidrachm represents £ grain, each, of Kino and 
Opium. 

Papaveris. — (Poppy.) Each fluidrachm represents 30 
grains of Poppy (Capsule). 

Pectoralis. — (Bateman's Pectoral Drops.) A popular 
mixture of Opium, Catechu, Camphor and Oil of Anise, 
containing 2^- minims Tincture of Opium (^ gr. Pulv 
Opium) in each fluidrachm. 

Persionis. — (Cudbear.) Intended as a coloring agent 
when a bright red tint or color is to be produced, particu- 
larly in acid liquids. 

Persionis Composita. — A mixture.of Cudbear and Cara- 
mel, intended as a coloring agent when a brownish-red tint 
or color is to be produced. 

Pimpineli^e. — (Pimpinella, P. Ger.) Each fluidrachm 
represents about 10 grains Pimpinella Root. 

Quillaee. — (Soap Bark.) Each fluidrachm represents 10 
grains Quillaia (Bark). 

Intended as an addition to mixtures containing sub- 
stances difficult otherwise to incorporate, such as Chloro- 
form, Oils, Balsams, Resins, etc. 

Rhei Aquosa. — (Rhubarb, Aqueous, P. Ger.) Each flui- 
drachm represents about 5f grains of Rhubarb, with alka- 
lies, flavored with Cinnamon. 

Rhei et Gentians. — Each fluidrachm represents 4 grains 
of Rhubarb and 1 grain of Gentian. 

Rhei Vinosa. — (Rhubarb, Vinous, P. Ger.) Each flui- 
drachm represents about 5 grains Rhubarb, with Bitter 
Orange and Cardamom, in sweet Sherry Wine. 

Saponis Viridis Composita. — A solution of about 15 per 
cent, of Green Soap and 2 per cent, of Oil of Cade. 

Strophantus — (Strophanthus.) From the seeds of Stro- 
phanthus Komb6, Oliver, deprived of their comose appen- 



556 THE NATIONAL FORMULARY. 

TlNCTURA — 

dage and fixed oil, of the strength and according to the 
formula of Dr. Frazer, of Edinburgh. 

Each fluidrachm represents 3 grains of Strophanthus. 
The Dose is from 2 to 10 minims. 
Tolutana Solubilis.— (Tolu, Soluble.) A so-called solu- 
ble essence of Tolu, for flavoring. 
Vanillini Composita. — A solution of Vanillin and Cou- 

marin, intended for flavoring. 
Zedoarle Amara. — (Zedoary Comp.) Similar, but not 
identical, with the Tinctura Carminativa — Wedelii, etc., 
formerly officinal in some Continental Pharmacopoeias. 
Each fluidrachm represents 1 5 grains of Zedoary, 7| grains 
. of Aloes, and 3f grains, each, of Rhubarb, Gentian r White 
Agaric and Saffron. 



VINA— WINES. N. F. 

The Wines, with a few exceptions, are prepared with Sherry 
Wine, and, in some cases, with the fortified Wine (Vinum 
album fortior, U. S. P.), when a larger proportion of Alcohol is- 
desirable in order better to preserve the preparation. 
Vinum Aurantii (for flavoring). 

Aurantii Compositum — (Elixir Aurantiorum Composi- 
tum). A combination of Bitter Orange Peel, Absinthium, 
Menyanthes, Cascarilla, Cinnamon and Gentian, in Sherry 
Wine. Useful as a stomachic tonic, in doses of one flui- 
drachm. 

Carnis — (Beef and Wine). Each fluidrachm represents 2 
grains of Extract of Beef. 

The Extract of Beef in this and similar preparations is- 
that which is prepared by Liebig's method. 

Carnis et Ferri — (Beef, Wine and Iron). Each flui- 
drachm represents 2 grains of Extract of Beef, and 2 mins. 
Tincture of Citro- Chloride (" Tasteless" Tincture) of Iron. 

Carnis, Ferri et Cinchona — (Beef, Wine, Iron an65 
Cinchona). Each fluidrachm represents 2 grs. Extract 
Beef, 2 minims Tincture Citro- Chloride Iron, and small 
quantities of Cinchona alkaloids, in Angelica Wine. 

Erythroxyli — (Coca.) Each fluid ounce represents 30 
grains of Erythroxylon Coca, in Claret Wine. 

Erythroxyli Aromatic um — (Coca, Arom.) Each fluid 
ounce represents 30 grains of Erythroxylon Coca, with 
Aromatics. 



THE NATIONAL FORMULARY. 55? 

VlNUM — 

Fraxini American.*: — (White Ash). Each fluidrachm rep- 
resents 30 grains of Fraxinus (bark). 

Pepsin i — (Pepsin). Each fluidrachm represents 1 grain of 
Pepsin (N. F.), equivalent to a digestive strength of 1 in 
500 of albumen. 

Picis — (Tar). A saturated solution of Tar, in Sherry Wine. 

Pruni Virginians — (Wild Cherry). Each fluidrachm 
represents 15 grains of W^ild Cherry, in Angelica Wine. 

Pruni Virginians Ferratum— (Wild Cherry, Ferrated). 
Each fluidrachm represents 5 minims of Tincture of Citro- 
Chloride of Iron and 13| grains of Wild Cherry, in An- 
gelica Wine. 



MISCELLANEOUS CHEMICALS. 

Acidum Hypophosphorosum Dilutum — Contains 10 per cent. 

of absolute Hypophosphorous Acid (H 3 P0 2 ). 
Acidum Metaphosphoricum Dilutum — Contains about 10 per 

cent, of absolute Metaphosphoric Acid. 

Whenever Pyrophosphate of Iron (U. S. P.) forms one of the in- 
gredients of a mixture containing Diluted Phosphoric Acid, the offici- 
nal tribasic acid is unsuitable, as it produces with the salt a gelatinous 
precipitate. If a clear mixture is required, the above preparation is to 
be used in place of the officinal. The same may be done when Phos- 
phate of Iron (U. S. P.) is prescribed, though the precipitate caused 
by the officinal acid in this case is not as bulky, and under certain 
conditions may not form at all. 
Caffeine Preparations — 

Caffein.e Citras Effervescens — (Effervescent Citrate 
of Caffeine). (A teaspoonful or 90 grains contains one 
grain of Caffeine). (See Effervescent Salts, page 549.) 
Caffein.e Sodio-Benzoas — (Caffeine Natro-Benzoicum). 
Contains 50 per cent, each of Caffeine and Benzoate of 
Sodium. It is soluble in two parts of Water. 
Caffeine Sodio-Salicylas — (Sodio- Salicylate of Caf- 
feine). Contains 50 percent, each Caffeine and Salicylate 
Sodium, and is soluble in two parts of water. 
Iron Compounds — 

Ferri Hypophosphis — (Ferric Hypophosphite). Soluble 
in Water when mixed with an equal weight of Citrate of 
Potassium. See also Liquor Ferri Hypophosphitis. 
Ferri et Quinine Citras Effervescens. 
Ferri Phosphas Effervescens. — (See Effervescent.) 
Other Iron Compounds are chiefly represented in the form 
of Liquors and Svrups, to which reference may be made. 
47* 



558 THE NATIONAL FORMULARY. 

Potassium Compounds — 

POTASSII BliOMIDUM EfFERVESCENS. 

Potassii Bromidum Effervescens cum Caffeusme. 

potassii cltras effervescens. 
In many Saline Drugs the therapeutic effect is greatly enhanced 
by solution in a considerable quantity of Water, which, when 
charged with Carbonic Acid Gas, is also rendered more agreeable 
as a draught. 

The effervescent salts furnish a convenient and effective method 
of administration of various combinations of remedies. The 
usual dose is one heaped teaspoonful, representing about 90 grains, 
dissolved in a wineglassful of Water. 



MISCELLANEOUS PREPARATIONS 

FOR EXTERNAL USE. 

Acetum Aromaticum. — (Aromatic Vinegar.) A combination! 
of fragrant Aromatics (Oils of Lavender, Rosemary, Juniper-, 
Peppermint, Cinnamon, Lemon and Cloves), containing 25 per 
cent, of Acetic Acid in Alcohol and Water. It is an anti-zymotic, 
and cooling application. 

Acidum Carbolicum Iodatum. — (Phenol Iodatum — Iodized 
Phenol.) A solution of 20 parts Iodine in Carbolic Acid, 76 parts 
with 4 parts of Glycerin. 

Balsamum Traumaticum. — (Turlington's Balsam — Friar's 
Balsam.) The officinal Tinctura Benzoini Composita is a simpli- 
fied preparation intended to replace this compound. 

Bismuthi Oxidum Hydratum. — A powder from which a mix- 
ture, known as Cremor Bismuthi or "Cream of Bismuth," may 
be readily prepared by triturating 20 parts with 80 parts of 
Water. 

Boroglycerinum. — (Glyceryl Borate — Boroglyceride.) — A soft 
solid from which the 50 per cent. Solution in Glycerin is prepared. 
(See Solution of Boroglyceride under Glyceriti.) 

Carbasus Carbolata. — (Carbolized Gauze.) This Gauze, 
when dry, contains 2.5 per cent, of Carbolic Acid. 

Carbasus Iodoformata. — (Iodoform Gauze.) Strength to be 
specified. The usual strength is 10 per cent. 

Ceratum Camphorae Compositum.— (Camphor Ice.) Moulded 
into small cakes suitable for popular use as an application to ex- 
coriated surfaces. It contains very small quantities of Benzoic 
and Carbolic Acids, and oil of bitter almond. 

Chloral Camphoratum. — (Chloral et Camphora.) A solution 
of equal parts of Chloral Hydrate and Camphor. 



THE NATIONAL FORMULARY. 559 

Collodions — 

Collodium Iodatum. — (Iodized Collodion.) Containing 
5 per cent. Iodine in Flexible Collodion. 

Collodium Iodoformatum. — (Iodoform Collodion.) Con- 
taining 5 per cent. Iodoform in Flexible Collodion. 

Collodium Salic ylatum Compositum. — (Corn Collo- 
dion.) Containing 11 per cent. Salicylic Acid and 2 per 
cent. Ext. Cannabis Indica in Flexible Collodion. 

Collodium Tiglii. — (Croton Oil Collodion.) Containing 
10 per cent. Croton Oil in Flexible Collodion. 
Gossypium Stypticum. — (Styptic Cotton.) 

lodoformum Aromatisatum. —(Deodorized Iodoform.) Contain- 
ing 4 per cent, of Cumarin. (See also Pulv. Iodoformi Dilu- 
tus, page 548.) 
The odor of Iodoform may also be more or less masked by many 
essential oils, for instance, those of peppermint, cloves, cinnamon, 
citronella, bergamot, sassafras, eucalyptus, etc. Another efficient 
covering agent is ground roasted coffee. The odor of Iodoform may be 
removed from the hands or any utensil which it has come in contact 
with, by washing with an aqueous solution of tannic acid. 

Sapo Viridis. — (Green Soap.) A soft soap made by saponi- 
fying Cotton Seed Oil with Potassa. The refined oil yields a 
product of yellowish color, which serves the same purpose as that 
of greenish tint. 

Soda cum Calce. — (London Paste.) Equal parts of Soda and 
Lime. 

Sodii Boro-Benzoas. — (Boro-Benzoate of Sodium.) A mix- 
ture of 3 parts Borate of Sodium and 4 parts of Benzoate of So- 
dium, in fine powder. 

Spongia Compressa. — (Sponge Tent.) The N. F. recom- 
mends that Sponge prepared for this purpose be preserved with 
twine wrapped around it. If the twine be removed, care should 
be observed to protect the Sponge against damp air. 

Spongia Decolorata. — Sponge bleached with potassium per- 
manganate. 



UNGUENTA— OINTMENTS. N. F. 

Unguentum Calamine. — (Unguentum Zinci Carbonatis 
Impuri. — Turner's Cerate.) Containing 17 percent. Car- 
bonate of Zinc (Imp.). 

Unguentum Camphor.e. — (Unguentum Camphoratum.) 
Containing about 20 per cent. Camphor 

Unguentum Fuscum. — (Unguentum Matris. — Mother's 
Salve.) Containing 50 per cent, of Camphorated Brown 
Plaster (N. F.). 



560 THE NATIONAL FORMULARY. 

Unguentum Picis Compositum. — (Tar, Comp.) Contain- 
ing Oil of Tar, 4 per cent. ; Tincture of Benzoin, 2 per 
cent. ; and Oxide of Zinc, 3 per cent. 
Unguentum Sulphuris Compositum. — (Wilkinson's 
Ointment. — Hebra's Itch Ointment.) 

Precipitated Carbonate of Calcium .... parts, 10 
Sublimed Sulphur, Oil of Cade, of each . . parts, 15 
Green Soap, and Lard, of each parts, 30 

The Lard is mixed with the Green Soap and Oil of Cade ; the Sub- 
limated Sulphur and Precipitated Carbonate of Calcium are then 
gradually incorporated. 



MISCELLANEOUS. 

Intended chiefly as stock preparations and general Formulas in 
dispensing. 

Liquor Carmini. — (Solution of Carmine.) A neutral solution 
of Carmine in Glycerin and Water (1 troy ounce to the pint). 

Liquor Coccineus. — (Cochineal Color.) An alkaline glycerol 
of Cochineal similar to that of the Am. Phar. Assoc. 

Mucilago Chondri. — (Irish Moss.) Two and one-half fluid 
ounces will emulsify 4 fluid ounces of Oil. Upon evaporation 
from glass plates the "scales" resulting constitute the Gelatinum 
Chondri, N. F. 

Mucilago Dextrini. — (Dextrin Mucilage.) A 25 per cent, 
solution of Dextrin. Two and one-half fluid ounces emulsify 4 
fluid ounces of Oil. 

Mucilago Salep. — (Salep Mucilage.) — To be prepared ex- 
tern-pore. 

Oleosacchara. — Oil Sugars. — (El^osacchara, P. Ger.) 

Any Volatile Oil 1 drop. 

Sugar 30 grains. 

Triturate to a fine powder when wanted for use. 

Oleosacchara Anisi, Foeniculi, Menthae pip., or of other aromatic 
drugs, are prepared from the corresponding essential oils according 
to this formula. 

Species Emollientes. — (Emollient Cataplasm, P. Ger.) A 
mixture of Althsea Leaves, Mallow Leaves, Melilot Tops, Matri- 
caria and Flaxseed, equal parts of each. 

Species Laxantes. — (St. Germain Tea, P. Ger.) A mixture 
of Senna, Elder Flowers, Fennel, Anise and Bitartrate of Potas- 
sium. 

Species Pectorales. — (Breast Tea, P. Ger.) A mixture of 
Althaea, Coltsfoot, Glycyrrhiza, Anise, Mullein Flowers and Orris 
Root. 



THE NATIONAL FORMULARY. 561 

Infusum pectorale (Pectoral Infusion, or Infusion of Pectoral 
Species) is made by infusing 1 troy ounce of the above in the 
usual manner, so as to obtain 10 fluid ounces of strained product. 

Talcum Purificatum. — (Purified Talc.) 

Tincturae JEthereae. — (Ethereal Tinctures.) The drug pro- 
perly comminuted, tr. ozs., 2 ; stronger Ether, 1 vol. ; Alcohol 2 
vols., enough to make n. ozs. 16. 

A General Formula for the preparation of Ethereal Tinctures 
of Belladonna, Castor, Digitalis, Lobelia, Valerian or other drugs. 

Gelatinum Chondri. — (For making Mucilage of Chondrus.) 



WEIGHTS AND MEASURES. 



One Pound, 
One Ounce, 
One Drachm, 
One Scruple, 
One Grain, 



APOTHECARIES' 
16 = 



WEIGHTS AND MEASURES. 



5 
B 



One Gallon, C 

One Pint, 

One Fluidounce, f ^ 
One Fluidraclim, f 3 
One Minim, Trj. 



12 Ounces 
8 Drachms 
3 Scruples 



8 Pints = 

16 Fluidounces = 

8 Fluidrachms = 



5,760 Grains. 

480 Grains. 

60 Grains. 

20 Grains. 

1 Grain. 

61,440 Minims. 

7,680 Minims. 

480 Minims. 

60 Minims. 

1 Minim. 



Note. — In prescribing, the troyounce, drachm, and grain, or the fluidounce, 
drachm, and minim, only should be used. 

RELATION OF WEIGHTS AND MEASURES OF THE U. S. 
PHARMACOPOEIA TO EACH OTHER. 

In distilled water at the temperature of 60°. 

One Pound = 0.7900031 Pint = 6,067.2238 Minims. 

One Ounce = 1.0533376 Fluidounces = 505.6019 Minims. 

One Drachm = 1.0533376 Fluidrachms = 63.2002 Minims. 

One Scruple = 21.0667 Minims. 

One Grain = 1.0533 Minims. 



One Gallon =10.1265427 Pounds 
One Pint = 1.2658178 Pounds 
One Fluidounce = 0.9493633 Ounce 
One Fluidrachm == 0.9493633 Drachm 
One Minim 



=58,328.8862 Grains. 
= 7,291.1107 Grains. 
= 455.6944 Grains. 
= 56.9618 Grains. 
= 0.9493 Grains. 



RELATION OF MEASURES OF THE U. S. 
TO CUBIC MEASURE. 



PHARMACOPOEIA 



One Gallon = 231. Cubic Inches. 

One Pint = 28.875 Cubic Inches. 

One Fluidounce = 1.80468 Cubic Inches. 
One Fluidrachm = 0.22558 Cubic Inch. 
One Minim = 0.00375 Cubic Inch. 



WEIGHTS AND MEASURES. 



563 



WEIGHTS AND MEASURES OF THE METRIC SYSTEM. 



MEASURES OF LENGTH. 

= 10,000 Metres. 
= 1,000 Metres. 
== 100 Metres. 
= 10 Metres. 

= the ten-millionth part of a quarter of the 

meridian of the earth. 
= the tenth part of one Metre, or 0.1 Metre. 
= the hundredth part of one Metre, or 0.01 

Metre. 
= the thousandth part of one Meter, or 0.001 

Metre. 

(A metre is equal to 39.37 inches ; a centimetre to T \ of an inch ; 
and a millimetre to -^ of an inch. 



One Myriametre 
One Kilometre 
One Hectometre 
One Decametre 
One METRE 

One Decimetre 
One Centimetre 

One Millimetre 



WEIGHTS. 

One Myriagramme = 10,000 Grammes. 
One Kilogramme = 1,000 Grammes. 
One Hectogramme = 100 Grammes. 
One Decagramme = 10 Grammes. 

One GRAMME = the weight of a cuhic centimetre of water at 

4°C. 
One Decigramme = the tenth part of one Gramme, or 0.1 Gramme. 
One Centigramme = the hundredth part of one Gramme, or 0.01 

Gramme. 
One Milligramme = the thousandth part of one Gramme, or 0.001 

Gramme. 



MEASURES OF CAPACITY. 

One Myrialitre == 10 cuhic Metres, or the measure of 10 Mil- 

liers of Water. 
One Kilolitre = 1 cuhic Metre, or the measure of 1 Millier 

of Water. 
One Hectolitre = 100 eubic Decimetres, or the measure of 1 

Quintal of Water. 
One Decalitre = 10 cuhic Decimetres, or the measure of 1 

Myriagramme of Water. 
One LITRE = 1 cubic Decimetre, or the measure of 1 

Kilogramme of Water. 
One Decilitre = 100 cubic Centimetres, or the measure of 1 

Hectogramme of Water. 
One Centilitre = 10 cubic Centimetres, or the measure of 1 

Decigramme of Water. 
One Millilitre = 1 cubic Centimetre, or the measure of 1 

Gramme of Water. 



564 



WEIGHTS AND MEASURES. 



RELATION OF METRICAL WEIGHTS TO WEIGHTS OF THE 
U. S. PHARMACOPOEIA. 







Exact 


Approximate 


Metrical Exact 
weights equivalent 
° ingrains. 


Approximate 


Metrica i 
weights. 


equivalents 
in grains. 


equivalents 
in grains. 


3 equivalents 
Troy weight. 


Milligrammes 


. 




Grammes. 




1 


— 


.0154 


l 

65 


1 


= 15.434 


gr. XV. 


2 


= 


.0308 


1 


2 


= 30.868 


5ss. 


3 


= 


.0463 


A 


3 


= 46.302 


W- 


4 


= 


.0617 


A 


4 


= 61.736 


3j- 


5 


= 


.0771 


i 


5 


= 77.170 


Biv. 


6 


= 


.0926 


l 
XT 


6 


= 92.604 


5iss. 


7 


:= 


.1080 


1 


7 


== 108.038 


9vss. 


8 


= 


.1234 


1 
8" 


8 


== 123.472 


5ij- 


9 


= 


.1389 


1 
7 


9 


= 138.906 


Bvij. 


Centigrammes. 




Decagrammes. 




1 


= 


.1543 


i 


1 


= 154.340 


5iiss. 


2 


= 


.3086 


i 


2 


= 308.680 


3v. 


3 


= 


.4630 


6 
TIF 


3 


= 463.020 


3^iiss. 


4 


= 


.6173 


TT 


4 


= 617.360 


5x. 


5 


= 


.7717 


3 


5. 


= 771.701 


3xiij. 


6 


= 


.9260 


A 


6 


= 926.041 


5xv. 


7 


= 


1.0803 


1 


7 


= 1,080.381 


5xviiij. 


8 


= 


1.2347 


H 


8 


= 1,234.721 


5xx. 


9 


= 


1.3890 


H 


9 


= 1,389.062 


3xxiij. 


Decigrammes 






Hectogrammes; 




1 


= 


1.543 


H 


1 


= 1,543.402 


I"j Bv- 


2 


= 


3.086 


3 


2 


= 3,086.804 


§^j 5iij- 


3 


= 


4.630 


4 * 


3 


= 4.630 206 


fix 3v. 


4 


= 


6173 


6 


4 


== 6,1 73. 609 


ffij 3^ij- 


5 


= 


7.717 


H 


5 


= 7,717.011 


B>j giv. 


6 


= 


9.260 


9 


6 


= 9,260.413 


ftj §vij. 


7 


= 


10.803 


11 


7 


= 10,803.816 


Ibj §x 5iv. 


8 


= 


12,347 


1% 


8 


= 12,347.218 


fti J ti 3 V - 


9 


= 


13.890 


14 


9 


== 13,890.620 


»ij 5^. 










Kilogramme. 












1 


== 15,434.023 


fcij £viij. 










Myriagramme. 












1 


=154,340.23 {""If: 

I5«c 5iv. 



WEIGHTS AND MEASURES. 



565 



RELATIONS OF WEIGHTS OF THE U. S. PHARMACOPOEIA 
TO METRICAL WEIGHTS. 



Fractions of a grain in 
grammes. 


Grains in equivalent 
metrical weights. 


Drachms, ounces, and 

pouDds in equivalent 

metrical weights. 


Grain 


Grammes. 


Grains. 


Grammes. 


Drachms. Grammes. 


l 
6T 


ss— 


0010 


1 


= 




0648 


1 


= 3 


887 


1 

"60 


= 


0011 


2 


= 




1295 


2 


= 7 


775 


~5~0 




0013 


3 


= 




1943 


3 


= 11 


66 


A 





0014 


4 


= 




2591 


4 


= 15 


55 


A 


= 


0016 


5 


i= 




3239 


5 


= 19 


43 


i 

3 6 


= 


0018 


6 


= 




3887 


6 


= 23 


32 


1 

IT) 


= 


0022 


7 


= 




4535 


7 


= 27 


21 


1 

To 


= 


0026 


8 


£= 




5183 






1 


= 


0027 


9 


= 




5831 


Ounces. 


A 


= 


0032 


10 


= 




6479 


1 


= 31 


103 


1 
1~6 


= 


0040 


12 


= 




7775 


2 


= 62 


206 


1 
lb 


= 


0043 


15 


= 




9718 


3 


= 93 


309 


1 

T2" 


= 


0054 


16 


= 


1 


036 


4 


= 124 


41 


1 

To" 


= 


0065 


20 


= 


1 


295 


5 


= 155 


51 


1 


= 


0081 


24 


= 


1 


555 


6 


= 186 


61 


= 


0108 


25 


= 


1 


619 


7 


== 217 


72 


■j 


^ 


0130 


30 


= 


1 


943 


8 


= 248 


82 


l 
4 
1 
3 


= 


0162 


40 


= 


2 


591 


9 


= 279 


92 


= 


0236 


50 


= 


3 


239 


10 


= 311 


03 


2 


= 


0324 


60 


= 


3 


887 


11 


= 342 


13 














Pounds. 














1 


= 373 


24 














2 


= 746 


49 
















3 


= 1119 


72 



RELATION OF MEASURES OF THE U. S. PHARMACOPOEIA 
TO METRICAL MEASURES. 



One Gallon = 

One Pint = 

One Fluidounce = 
One Fluidrachm = 
One Minim = 



3.785 Litres. 
4.273 Decilitres. 
2.957 Centilitres. 
3.697 Millilitres. 
0.061 Millitre. 



48 



566 



WEIGHTS AND MEASURES. 



RELATION OF METRICAL MEASURES TO MEASURES OF 
THE U. S. PHARMACOPCEIA. 



One Myrialitre 


= 


2641.9 


Gallons. 


One Kilolitre 


= 


264.19 


a 


One Hectolitre 


= 


26.419 


it 


One Decalitre 


= 


2.641 


(< 


One Litre 


= 


2.113 


Pints. 


One Decilitre 


= 


3.381 


Fluidounces. 


One Centilitre 


= 


2.705 


Fluidrachms 


One Millilitre 


= 


16.231 


Minims. 



THE METRIC SYSTEM IN MEDICINE, 



For Prescription Writing. 



~n\_) or gr. j equals 

f5J ° r 5J 
f 5J or 5J 



06 Gm. 



The decimal line instead of points makes errors impossible. 

As .06 (Drug) is less than a grain, while 4. and 32. (Vehicle) 
are more than the drachm and ounce, there is no danger of giving 
too large doses of strong drugs. 

C.C. (cubic centimetres) used for Gms. (Grammes) causes an 
error of 5 per cent, (excess). 

A teaspoonful is usually 5 Gms. ; a tablespoonful 20 Gms. 



THERAPEUTIC SUGGESTIONS; 

OR 

INDEX OF DISEASES 

REFERRED TO IN THIS WORK. 



ABORTION 
iron and potassium chlo- 
rate, 48 
Abscesses 

alcohol, 145 

belladonna, 195 

cantharidal collodion, 269 

carbolic acid, 109 

cod-liver oil, 383 

flaxseed poultice, 361 

ice, 180 

iodine, 341 

sulphide of lime, 213 
Acne faciei 

calcium sulphide, 213 

sulphur, 475 
Acute mania 

arnica, 187 

belladonna, 196 

bromide of potassium, 439 

chloral, 235 

conium, 273 

dulcamara, 292 

hyoscyamine, 33.7 

Indian hemp, 220 

opium, 393 
Ague 

apiol, 504 

arsenic, 102 

chinolin, 264 

copper, 282 

dogwood, 279 

eucalyptus, 399 

lemons, 361 

quinine, 258 



Ague — 

salicin, 453 

thuja, 485 
Ague-Cake (see Spleen, Enlarged) 
Albuminuria 

arsenic, 104 
. benzoate of calcium, 204 

ergot, 294 

fuchsine, 503 

(see also Bright's disease) 
Alcoholism 

hop-tea, 323 

hydrastis, 336 

tincture of capsicum, 225 
Amaurosis 

strychnine, 378 
Amenorrhea 

aloes, 155 

apiol, 504 

cantbarides, 222 

chloride of gold and sodium, 193 

cimicifuga, 251 

cotton-root bark, 320 

digitalis, 290 

ergot, 294 

hedeoma, 323 

hiera picra, 156, 548 

iron, 302 

marjoram, 402 

myrrb, 376 

pennyroyal, 323 

rue, 451 

savin, 451 

tansy, 481 

thuja, 485 



568 



INDEX OF DISEASES. 



Amenorrhea— - 

xanthoxylum, 495 
Anemia 

chalybeate waters, 181 

cod-liver oil, 382 

dialyzed iron, 308 

iron, 306 

phosphate of lime, 213 

phosphorus, 408 

sulphate of manganese, 369 

(see also Leucocythsemia) 
Aneurism 

digitalis, 288 

ergotine injections, 294 

iodide of potassium, 343 
Angina (see Sore throat) 
Angina pectoris 

hypodermic injection of mor- 
phine, 396 

nitrite of amyl, 167 

nitrite of sodium, 504 

nitro-glycerin, 169 

opium, 396 
Aphthous sore-mouth 

borax, 107 

chlorate of potassium, 430 

hyposulphite of sodium, 468 

sulphurous acid, 131 
Apoplexy 

croton oil, 390 
Arsenical poisoning 

antidotes, 99 

dialyzed iron, 308 
Ascites (see Dropsy) 
Asthma 

aether, 141 

antimony, 174 

antipyrin, 500 

arsenic, 102 

atropine, 199 

belladonna, 199, 203 

caffeine, 210 

chloral, 236 

chloroform, 243 

cod-liver oil, 382 

ether, 141 

eucalyptus, 299 

grindelia, 320, 503 

hydriodic acid, 347 

ipecacuanha, 349 

lobelia, 365 

nitre papers, 435 



Asthma — 

nitrite of amyl, 168 
nitro-glycerin, 169 
opium, 396 
pepsin, 403 
pilocarpin, 421 
quebracho, 505 
stramonium, 474 
strychnine, 379 
tobacco-smoking, 480 
turpentine stupes, 482 

Atheroma 
digitalis, 284 



BILIARY COLIC (see Gall- 
stones) 
Biliousness 

acids, 58 

blue pill, 330 

ipecacuanha, 352 

nitro-hydrochloric acid, 124 

taraxacum, 481 

(see also Hepatic disorders) 
Bites 

excision, etc., 517 

potassium permanganate, 433 
Bladder affections (see Cys- 
titis) 
Boils (see Abscesses) 

iodine, 342 
Bowel affections (see Diarrhoea) 
Brain-affections 

blisters, 223 

bromide of potassium, 438 

croton oil, 390 

ice, 180 

iodide of potassium, 342 

scammony, 460 

(see also Meningitis and Syph- 
ilis) 
Brain-softening 

phosphorus, 406 

zinc phosphide, 410 
Bright's disease 

alkalies, 435 

apocynum, 176 

arsenic, 104 

benzoate of calcium, 204 

chloride of gold and sodium, 192 

copaiba resin, 277 

compound jalap powder, 354 



INDEX OF DISEASES. 



569 



Bright's disease — 

cream of tartar, 432 

diaphoretics, 70 

digitalis, 289 

ergot, 294 

fuchsine, 503 

gallic acid, 312 

iron, 307 

jalap, 354 

pilocarpin, 418 

potash salts, 435 

scoparius, 461 

water, 177 
Bromide acne 

arsenic, 440 
Bronchitis 

aether, 141 

ammonia, 161 

ammoniac, 159 

antimony, 174, 175 

arsenic, 102 

asafetida, 189 

balsam of Peru, 193 

balsam of Tolu, 194 

benzoin, 204 

brown mixture, 319 

carbolic acid inhalations, 111 

caulophyllum, 230 

chloral, 237 

chloride of ammonium, 161 

cod-liver oil, 383 

colchicum. 267 

copaiba, 277 

corrosive sublimate, 329 

digitalis, 288 

eucalyptus, 299 

expectorants, 76 

garlic, 153 

hydriodic acid, 347 

iodide of potassium, 344 

ipecacuanha, 349 

jalap, 354 

licorice, 318 

linseed tea, 361 

lobelia, 364 

mercury, 329 

mustard plasters, 467 

myrrh, 376 

nitre papers, 435 

oil of amber, 387 

opium. 396 

phosphoric acid, 125 

48 



Bronchitis — 

senega, 463 

squill, 461 

steam, 180 

sulphur, 476 

tar vapor, 423 

tartar emetic, 175 

terebene, 506 

thuja, 485 

tobacco, 480 

turpentine, 482, 484 

turpentine stupes, 482 

wild-cherry bark, 443 
Bronchocele (see Goitre) 
Broncho-pneumoxia 

antimony, 173 

(see Bronchitis and Pneumo- 
nia) 
Bubo 

ice, 180 

(see also Abscesses) 
Burns 

bicarbonate of sodium, 470 

carbolic acid, 109 

carbonate of lead, 426 

carron oil, 362 

collodion, 269 

cotton, 319 

petrolatum, 404 

warm-bath, 180 



CALCULUS (phosphatic) 
nitric acid injections, 123 

opium, 395 

potassa, 435 

(see also Gravel) 
Cancer 

arsenic, 101 

blood-root, 453 

chloride of zinc, 496 

chloroform, 245 

citric acid, 114 

iodoform, 348 

opium, 396 

sulphuric acid, 130 
Cancrcm oris 

nitric acid, 123 
Carbuncles 

iodine, 341 
Cardiac disease (see Heart dis- 
ease) 
* 



570 



INDEX OF DISEASES. 



Cardiac dropsy (see Dropsy) 
Cardiac palpitation (see Heart 

disease) 
Caries 

cod-liver oil, 383 

sulphuric acid, 130 
Catarrh (chronic) 

asafetida, 189 

iodoform, 348 

ipecacuanha, 349 

eupatorium, 300 

thuja, 485 

(see also Bronchitis and Co- 
ry z a) 
Cerebral disorders (see Brain 

affections) 
Chafing (see Intertrigo) 
Chancre (see Syphilis) 
Chancroid 

lunar caustic, 185 
Chapped hands 

collodion, 269 

glycerin, 317 

sperDiaceti cerate, 232 
Chilblains 

carbolated petrolatum, 404 

tr. iodine, 331 
Chills and fever (see Ague) 
Chloasma 

sulphurous acid, 131 

(see also Skin diseases) 
Chlorosis 

chalybeate waters, 181 

iron, 306 

solution of dialyzed iron, 308 

(see also Anaemia) 
Cholera 

cajuput oil, 211 

camphor, 217 

cold affusions, 179 

hypodermic injections of mor- 
phine, 396 

nitrite of amyl, 168 

sulphuric acid, 131 
Cholera infantum (see Diar- 
rhoea) 
Cholera morbus 

acetate of lead, 427 

ipecacuanha, 362 

opium, 396 

sulphuric acid, 131 

(See also Diarrhoea) 



Chordee 

camphor, 218 
Chorea 

aether, 141 

arsenic, 102 

belladonna, 201 

bromide of iron, 305 

bromide of potassium, 439 

chloral, 236 

chloroform, 245 

cimicifuga, 251 

cold affusion, 179 

conium 272 

copper, 282 

curare, 501 

ether-spray, 141 

eucalyptus, 299 

hemlock, 272 

iron, 305 

manganesium sulphate, 369 

physostigma, 412 

picrotoxin, 416 

strychnine, 379 

sulphate of zinc, 497 
Chronic mania 

cimicifuga, 251 

cod-liver oil, 382 

ergot, 293 

hemlock, 272 
Chronic nephritis (see Bright's 

disease) 
Cinchonism 

hydrobromic acid, 114 
Cirrhosis of kidneys 

chloride of gold and sodium, 
192 

(see also Bright's disease) 
Cirrhosis of liver 

arsenic, 104 

chloride of gold and sodium, 
192 

(see also Hepatic disorders) 
Colds (see Coryza) 
Colic 

anise, 170 

asafetida, 189 

belladonna, 198 

cajuput oil, 211 

chloroform, 250 

cloves, 229 
, compound tincture of carda- 
mom, 228 



INDEX OF DISEASES. 



57L 



Colic — 

ether, 141 

fennel tea, 170 

flaxseed poultices, 361 

ginger, 498 

mustard, 466 

opium, 395 

pennyroyal, 323 

tansy, 481 

warm bath, 180 
Colica Pictootjm (see Painter's 

colic) 
Color-Blindness 

fuchsine, 503 

santonin, 455 
Condylomata 

acid nitrate of mercury, 327 

black-wash, 327 

calomel, 327 

chromic acid, 113 

(See also Syphilis) 
Congestion of brain 

bromide of potassium, 438 

compound jalap powder, 354 

croton oil, 390 

elaterium, 292 
Congestion of spinal cord 

belladonna, 198 

ergot, 293 
Conjunctivitis 

alum, 157 

castor oil, 386 

cod-liver oil, 383 

iodoform, 348 

lard, 140 

jequirity, 503 

ointment of nitrate of mercury, 
335 

opium fomentations, 393 

lead acetate, 426 

silver nitrate, 185 

zinc sulphate, 497 
Constipation 

aloes, 154 

alum, 157 

asafetida, 189 

belladonna, 198 

cassia, 229 

castor oil, 386 

colocynth, 270 

compound licorice powder, 319 

confection of senna, 465 



Constipation — 

cream of tartar, 434 

croton oil, 390 

elaterium, 292 

gamboge, 215 

glycerin suppositories, 318 

jalap, 354 

juglans, 355 

magnesii sulph., 367 

leptandra, 359 

molasses, 452 

nux vomica, 380 

olive oil, 385 

ox-gall, 302 

physostigma, 414 

picrotoxin, 416 

podophyllum, 429 

purgatives, 81 

rhubarb, 447 

sambucus, 453 

seidlitz powders, 133, 470 
• senna, 370, 464 

strychnine, 379 

sulphur, 476 

tamarinds, 481 

taraxacum, 481 

tobacco, 481 

wahoo, 300 
Consumption (see Phthisis) 
Contusions (see Sprains and 

Bruises) 
Convulsions, epileptic (see Epi- 
lepsy) 
Convulsions, hysterical (see 

Hysteria) 
Convulsions, infantile 

asafetida, 189 

bromide of potassium, 439 

chloral, 236 

chloroform, 245 

conine, 273 

emetics, 74 

ether, 141 

garlic, 153 

hemlock, 273 

mustard baths, 466 

oil of amber, 388 

warm bath, 180 
Con v uls i on s , pd erper al 

chloral, 236 

chloroform, 245 

veratrum viride, 493 



572 



INDEX OF DISEASE! 



Convulsions, uremic (see Urse- 

mic coma) 
Corns 

acetic acid, 97 

(see Warts) 
Coryza 

aconite, 137 

alcohol, 149 

asafetida, 189 

bismuth, 206 

boneset tea, 300 

camphor, 218 

creasote, 279 

cubebs, 280 

Dover's powder, 398 

glycerite of tannin, 311 

horehound, 370 

licorice, 318 

opium, 396 

quillaia, 445 

salicin, 453 
Costiveness (see Constipation) 
Cough 

belladonna, 201 

chloroform, 243 

codeine, 401 

flaxseed tea, 362 

gelsemium, 315 

glycerite of tannic acid, 311 

hydrocyanic acid, 121 

hyoscyamus, 337 

ipecacuanha wine, 354 

morphine, 399 

opium, 396, 399 

oxalate of cerium, 231 
Cracked nipples 

benzoin, 204 

cacao butter, 388 

collodion, 270 

tannic acid, 311 
Croup, pseudo-membranous 

alum, 157 

brominized solution, 441 

chlorate of potash, 434 

ipecacuanha, 354 

lactic acid, 122 

lime-water, 212 

steam, 180 

(see also Diphtheria, and 
Spasm of the larynx) 
Croup, spasmodic 

alum, 157 



Croup, spasmodic — 

antimony, 174 

squill, 461 
Cystitis 

benzoin, 204 

buchu, 209 

copaiba, 277 

cubebs, 280 

hyoscyamus, 334 

iron, 307 

juniper, 356 

pareira, 402 
. turpentine, oil of, 484 

uva ursi, 489 



DEBILITY 
alcohol, 149 

chalybeate .waters, 181 

cod-liver oil, 382 

gentian, 316 

iron, 302 

phosphorus, 406 

quinine, 257 

strychnine, 378 

tonics, 87 

(see also Anaemia) 
Delirium tremens 

antimony, 173 

arnica, 187 

bromide of potassium, 439 
. chloral, 147, 235 

digitalis, 286 

hops, 323 

hyoscyamine, 338 

lupulin, 323 

musk, 374 

n ux vomica, 378 

opium, 393 

strychnine, 379 

veratrum viride, 493 
Diabetes 

almonds, 165 

bromide of potassium, 440 

codeine, 401 

glycerin, 318 

opium, 397 

phosphoric acid, 125 
Diabetes insipidus 

ergot, 294 
. pilocarpus, 418 



INDEX OF DISEASES. 



573 



DlARRHCEA 

acetate of lead, 427 
acids, 58 
alum, 157 
arsenic, 103 
bismuth, 206 
blackberry, 450 
cajuput oil, 211 
campbor, 218 
castor oil, 386 
catechu, 230 
chalk, 213 
chestnut leaves, 229 
cinnamon, 265 
copper, 283 

corrosive sublimate, 330 
ergot, 295 
geranium, 316 
gum arabic, 97 
ipecacuanha, 353 
iron, 307 
kino, 357 
krameria, 357 
licorice, 319 
lime-water, 213 
logwood, 322 
nitrate of iron, 307 
opium, 396 
oxide of zinc, 498 
pepsin, 403 

phosphate of lime, 213 
podophyllum, 429 
prinos, 442 
quebracho, 505 
resin, 446 
rhubarb, 447 
rhus glabra, 448 
sulphuric acid, 131 
tannic acid, 311 
turpentine, oil of, 483 
zinc sulphocarbolate, 498 
Diphtheria and Croup 
alcohol, 198 
ammonia, 162 
brominized solution, 441 
carbolic acid, 111 
chlorate of potassium, 436 
chlorine water, 183 
chromic acid, 113 
citric acid, 113 
hydrochloric acid, 116 
iodoform, 348 



Diphtheria and Croup — 

ipecacuanha, 350 

lactic acid, 122 

lime inhalations, 212 

tincture of iron, 307 

turpentine, 483 
Diphtheritic paralysis 

strychnine, 379 
Dislocations 

antimony, 174 

chloroform, 245 

hemlock, 273 
Drink-craving 

tincture of capsicum, 225 
Dropsy 

apocynuni, 176 

blisters, 223 

citrate of caffein, 210 

comp. jalap powder, 354 

copaiba resin, 277 

cream of tartar, 435 

digitalis, 289 

elaterium, 292 

gamboge, 216 

juniper, 355 

pilocarpin, 421 

potash salts, 435 

scammony, 460 

scoparius, 461 

spirit of nitre, 153 

squill, 460 

wintergreen, 233 
Dysentery 

camphor, 219 

ergot, 295 

gum arabic, 97 

ipecacuanha, 352 

krameria, 357 

opium, 396 

rhatany, 357 

wax, 231 
Dysmenorrhea 

apiol, 504 

chloride of gold, 193 

clove-tea, 229 

manganese sulphate, 369 

viburuum, 494 
Dyspepsia 

acids, 57 

aloes, 155 

arsenic, 103 

asafetida, 188 



574 



INDEX OF DISEASES. 



Dyspepsia — 

belladonna, 201 

bismuth, 205 

bromide of potassium, 440 

carbolic acid, 112 

carbonated waters, 181 

chamomile, 171 

charcoal, 225 

colchicum, 267 

columbo, 214 

digitalis, 291 

emetics, 73 

eucalyptus, 299 

gentian, 316 

gold, 192 

hydrastis, 336 

hydrocyanic acid, 118, 121 

hydrochloric acid, 116 

lactic acid, 122 

lappa, 358 

lime-water, 213 
, magnesia, 367 

magnolia, 369 

nux vomica, 379 

ox-bile, 302 

pepsin, 403 

picrotoxin, 416 

potash, 434 

prinos, 442 

quassia, 445 

quinine, 257 

rhubarb, 447 

rumex, 450 

sanguinaria, 454 

senna, 464 

soda, 470 

soda-mint, 471 

strychnine, 379 

sulphate of manganese, 369 

sulphurous acid, 131 

taraxacum, 481 

thoroughwort, 300 



EAR DISCHARGES 
boric acid, 107 
Eczema 

arsenic, 104 

bicarbonate of potassium, 432 

bismuth, 206 

chloral, 240 



Eczema — 

glycerite of tannic acid, 311 

hydrocyanic acid, 118 

iodoform, 348 

lead-plaster and vaseline, 
507 

lead-water, 425 

liquor potassse, 432 

phosphorus, 408 

soda, 469 

tar, 424 

thymol, 485 

tincture of green soap, 458 

viola tricolor, 495 

zinc oleate, 497 

(see also Skin diseases) 
Emphysema 

ipecacuanha, 350 

quebracho, 469 
Empyema 

tr. iodine, 332 
Epilepsy 

belladonna, 201 

bromide of ammonium, 164 

bromide of potassium, 438 

calabar bean, 412 

copper, 282 

curare, 501 

iron, 305 

nitrite of amyl, 166 

nitrite of sodium, 504 

nitro-glycerin, 169 

physostigma, 412 

picrotoxin, 416 

silver, 185 
Epistaxis 

ergot, 294 

iron, 305 

(see Hemorrhage) 
Erysipelas 

aconite, 137 

collodion, 269 

elm-poultice, 488 

lead-water, 425 

liquor gutta-percha, 243, 322 

nitrate of silver, 185 

pilocarpine, 421 

quinine, 255 

sulphate of iron, 305 

tincture of iron, 307 
- zinc ointment, 497 



INDEX OF DISEASES. 



575 



RACIAL NEURALGIA 
JL' aconite, 135 

gelsemium, 313 

(see also Neuralgia) 
Fainting (see Syncope) 
Fatigue 

alcohol, 146 

coca leaves, 297 
Favus 

black-wash, 328 

(see Skin diseases) 
Felon 

carbolic acid, 111 
Fetid expectoration 

creasote, 279 

salicylic acid, 125 
Fetid perspiration 

ointment of boric acid, 107 
Fever intermittent (see Ague) 
Fevers 

acacia solution, 97 

acids, 57 

aconite, 137 

alcohol, 148 

althaea, 156 

antipyretics, 65 

an ti pyrin, 500 

baths, 180 

citric acid, 114 

diaphoretics, 70 

digitalis, 289 

effervescing draughts, 114, 470 

gum arabic, 97 

liquor ammonii acetatis, 163 

opium, 393 

quinine, 254 

refrigerants, 60 

resorcin, 506 

salicylic acid, 126 

tartaric acid, 133 

turpentine, oil of, 483 

vinegar, 98 
Fissure of rectum 

belladonna, 195 
Flatulence 

carbolic acid, 112 

charcoal, 226 

cloves, 228 

ether, 141 

fennel, 170 

nux vomica, 380 

pennyroyal, 323 



Flatulence — 
soda-mint, 471 
sulphurous acid, 132 
xanthoxylum, 495 
(see also Dyspepsia) 

Flooding, post-partum 
ergot, 295 
iron injections, 304 
(see also Hemorrhage) 



GALL-STONES 
belladonna, 200 
chloroform, 245 
hypodermic injections of mor- 
phine, 400 
opium, 395 
warm bath, 180 

GaSTRALGIA 

blisters, 222 

codeine, 401 

malt liquors, 324 

manganesium sulphate, 369 

silver nitrate, 185 

(see also Colic) 
Gastro-Enteric inflammation 

gum arabic, 97 

(see also Diarrhoea and Dysen- 
tery) 
General Paralysis 

physostigma, 412 
Glauco'ma, acute 

physostigmine, 413 
Gleet 

copper sulphate, 282 

iron, 307 

storax, 474 

turpentine, oil of, 484 

uva ursi, 489 

(see also Gonorrhoea) 
Goitre 

biniodide of mercury, 328 

tincture of iodine, 342 
Gonorrhoea 

alum, 157 

aluminii sulphas, 158 

bismuth, 205 

buchu, 209 

copaiba, 276 

cubebs, 280, 281 

fluid extract of matico," 371 

hydrastis canadensis, 336 



576 



INDEX OF DISEASES. 



Gonorrhoea — 

infusion of pomegranate, 320 

potassium bromide, 440 

silver nitrate, 185 

storax, 474 

sulphate of copper, 282 

sulphate of zinc, 497 

tannic acid, 311 

turpentine, 483 

zinc sulphocarbolate, 498 
Gout 

carbonated water, 181 

colchicum, 267 

iodide of potassium, 345 

lithium, 363 

potash, 433 

salicylic acid, 126 

veratrine, 492 
Granular lids 

sulphate of copper, 282 
Gravel 

chloroform, 245 

lithia, 363 

salicylate of sodium, 127 

HiEMATEMESIS 
gallic acid, 311 
(See also Haemorrhage) 

HEMATURIA 

gallic acid, 312 
turpentine, oil of, 483 

HEMOPTYSIS 

acetate of lead, 427 
alum, 157 
atropine, 199 
digitalis, 287 
ergot, 294 
gallic acid, 311 
ipecacuanha, 351 

HAEMORRHAGE 

acetate of lead, 427 
alum, 157 
cinnamon, 265 
collodion, 289 
digitalis, 287 
ergot, 294 
erigeron, oil of, 483 
ice, 180 
iron, 304 
lead, 427 



Hemorrhage — 

matico, 371 

opium, 396 

tannic acid, 311 

turpentine, oil of, 483, 484 

(see also Menorrhagia, etc.) 
Hemorrhoids 

belladonna, 195 

ergot, 294 

glycerin, 317 

hamamelis, 322 

hydrastis, 336 

iodoform, suppositories, 348 

ointment of galls, 311 

opium fomentations, 393 

nitric acid, 123 

pepper, 417 

stramonium, 474 

sulphur, 476 
Hay-asthma or Hay-fever 

arsenic, 102 

hydriodic acid, 347 

quinine, 256 
Headache 

aconite, 135 

guarana, 321 

iron, 306 

nitro-glycerine, 169 

podophyllum, 429 

potassium bromide, 439 

tincture of nux vomica, 380 

valerian, 490 

valerianate of ammonia, 522 

vinegar, 98 

(see also Neuralgia) 
Heartburn 

magnesia, 367 

nux vomica, 380 

soda-mint, 471 

(see also Dyspepsia) 
Heart-clot 

ammonia, 162 
Heart-disease 

aconite, 137 

belladonna, 198 

casca bark, 501 

cocaine, 298 

convallaria, 501 

comp. jalap powder, 354 

digitalis, 287 
- elaterinum, 292 

ether, 141 



INDEX OF DISEASES. 



5tt 



Heakt-disease — 

hydrocyanic acid, 118 

iron, 306 

morphine, 396 

potash-salts, 435 

scoparius, 462 

strychnine, 379 

veratrum viride, 493 
Hepatic disorders 

ammonium chloride, 164 

hlue pill, 330 

chelidonium, 232 

citric acid, 113 

hydrastis, 336 

ipecacuanha, 353 

leeches, 507 

nitric acid, 123 

nitro-hydroehloric acid, 124 

podophyllum, 429 

rhubarb, 447 

rumex, 450 

sodium phosphas, 470 

xanthoxylum, 495 
Hernia 

chloroform, 245 

hemlock, 273 

tartar emetic, 174 

warm bath, 180 
Herpes zoster 

collodion, 269 

(see Skin diseases) 
Hiccough 

musk, 374 

oil of amber, 387 
Hydrocele 

carbolic acid, 109 

tr. iodine, 342 
Hydrophobia 

woorara, 502 
Hydrothorax 

blisters, 223 

pilocarpin, 421 

scoparius, 463 

(see also Pleurisy and Dropsy) 
Hyperpyrexia 

quinine, 254 

resorcin, 506 

salicylic acid, 126 

(see also Fevers) 
Hypochondriasis 

eimicifuga, 251 



Hypochondriasis — 

cypripedium, 284 

(see Acute and Chronic 
mania) 
Hysteria 

asafetida, 188 

chloroform, 243 

cloves, 228 

cold water, 180 

ether, 141 

compound spirits of, 152 

eucalyptus, 299 

hemlock, 273 

musk, 374 

oil of amber, 387 

sumbul, 477 

valerian, 490 

valerianate of zinc, 498 



TMPACTION OF FiECES 
1 seidlitz powders, 470 

(see Constipation) 
Impetigo 

arsenic, 104 

(see Skin -diseases) 
Impotence 

phosphorus, 410 
Incontinence of urine 

belladonna, 199 

bromide of potassium, 435 

buchu, 209 

chloral, 236 

collodion, 269 

ergot, 295 

santonin, 456 

strychnine, 379 
Indigestion 

arsenic, 104 

ipecacuanha, 353 

manganese sulphate, 369 

(see Dyspepsia) 
Infantile convulsions (see Con- 
vulsions, Infantile) 
Inflammations 

alcohol, 147 
Insanity (see Acute and Chronic 

mania) 
Insomnia 

belladonna, 196 

butyl-chloral, 241 



578 



INDEX OF DISEASES. 



Insomnia — 

chloral, 235 

cypripedium, 284 

hyoscyamus, 337 

malt liquors, 324 

narcotics, 77 

opium, 393 

paraldehyde, 504 

potassium hromide, 439 
Intermittent fevee (see Ague) 
Intertrigo 

bismuth, 205 

(see also Skin diseases) 
Intestinal obstruction 

(see Obstruction of bowels) 
Iritis 

atropine, 196 

blisters, 222, 507 

leeches, 507 

oil of turpentine, 484 
Irritable Heart (see Heart dis- 
ease) 
Irritable Stomach (see Vomit- 
ing) 
Itch (see Scabies) 
Itching (see Pruritus) 



JAUNDICE 
J podophyllum, 429 

rhubarb, 447 

sanguinaria, 454 

soda, 470 

(see also Hepatic disorder) 
Joint Affections 

blisters, 223 

cod-liver oil, 383 

digitalis, 285 

iodine, 331 

liquor potassse, 432 

oleate of mercury, 333 



K 



IDNEY COMPLAINT 

comp. jalap powder, 354 
copaiba, 276 
digitalis, 287 
gallic acid, 311 
iron, 307 
pipsissewa, 233 
potash salts, 435 
(see also Bright's disease) 



TABOR 

L chloral, 236 

chloroform, 244 

cotton-root bark, 320 

ergot, 294 

opium, 393 

quinine, 254 

ustilago, 488 
Laryngismus stridulus (see 

Spasm of the larynx) 
Laryngitis (see Sore throat) 
Lead Poisoning 

(see Plumbisin) 
Leprosy 

copaiba, 276 

(see Skin diseases) 

L!iUCOCYTHjEM1A 

phosphorus, 407 

(see also Anaemia) 
Leucorrhosa 

alum, 157 

aluminium sulphate, 158 

bismuth, 205 

ergot, 296 

fluid extract matico, 371 

iron injections, 305 

lime-water, 212 

liquor potassse, 432 

sulphate of zinc, 497 

tannic acid, 311 

white-oak bark, 445 
Lichen 

arsenic, 104 

(see Skin diseases) 
Li TH i a sis 

borax, 107 

(see also Gout) 
Liver disease (see Hepatic dis- 
orders) 
Locomotor ataxia 

physostigma, 412 

silver nitrate, 185 

silver oxide, 185 
Lumbago (see Myalgia) 
Lumbricoids (see Worms) 
Lung Disease (see Phthisis, 

Pneumonia, and Bronchitis) 
Lupus 

arsenic, 103 

carbolic acid, 111 
' copaiba, 276 

(see also Skin diseases) 



INDEX OF DISEASES. 



579 



MALARIAL FEVERS 
(see Ague) 
Mania (see -Acute or Chronic 
mania) 

arnica, 187 
Mastitis 

belladonna, 196 
Mastodynia 

belladonna, 196 
Measles 

phosphorus, 408 
Meningitis 

blisters, 223 

bromide of potassium, 439 

ice, 180 

opium, 394 
Menorrhagia 

atropine, 199 

bromide of potassium, 440 

cinnamon, 265 

digitalis, 287, 290 

ergot, 294 

gallic acid, 312 

oil of erigeron, 483 

oxide of silver, 185 

(see also Haemorrhage) 
Mental failure 

chloride of gold, 192 
Migraine 

aconite, 136 

antipyrin, 500 

caffeine, 210 

cypripedium, 284 

guarana, 210, 321 

Indian hemp, 220 

nitrite of amyl, 166 

nux vomica, 380 

podophyllum, 429 

valerian, 490 
Mitral disease (see Heart dis 

ease) 
Myalgia 

ammonium chloride, 161 

atropine injections, 201 

boneset tea, 300 

chloroform, 243 

cimicifuga, 251 

gelsemium, 313 

morphine injections, 400 

mustard plasters, 466 
Myelitis, chronic 

belladonna, 199 



N2EVUS 
ethylate of sodium, 503 
Narcotic poisoning 

blisters, 223 

charcoal, 226 

mustard emetics, 467 

zinc sulphate, 498 
Necrosis 

sulphuric acid, 130 
Nervous debility 

iron, 305 

phosphorus, 406 

strychnine, 378 

(see also Debility) 
Nbrvous headache 

citrate of caffein, 210 

Indian hemp, 220 

valerian, 490 

valerianate of ammonia, 522 

(see also Headache) 
Nervous insomnia 

chloral, 235 

malt liquors, 324 

musk, 374 

paraldehyde, 504 

(see also Insomnia) 
Nervousness 

asafetida, 188 

camphor, 217 

eucalyptus, 299 

valerianates, 136 

(see Hysteria) 
Neuralgia 

aconite, 135 

aeon i tine, 138 

alcohol, 146 

ammonium chloride, 161 

apiol, 504 

arsenic, 102 

belladonna, 195 

blisters, 222 

butyl-chloral, 241 

cannabis Indica, 220 

chloral, 234 

chloral-camphor, 240 

chloroform, 243 

cochineal, 265 

cod-liver oil, 382 

croton-chloral, 241 

ether, 141 

gelsemium, 313 

guarana, 321 



580 



INDEX OF DISEASES. 



Neuralgia — 

hydrocyanic acid, 118 

hypodermic injections of mor- 
phine, 400 

Indian hemp, 220 

iodoform, 348 

iron, 305 

menthol, 373 

mustard-plaster, 466 

nitrite of amyl, 166 

oil of peppermint, 373 

opium, 395 

osinic acid, 504 

phosphide of zinc and nux vo- 
mica, 410 

quinine, 257 

salicin, 453 

turpentine stupes, 483 

valerianate of quinine, 253 

veratrine ointment, 491 

(see also Headache, Toothache, 
Myalgia, and Pleurodynia) 
Night-sweats 

acetic acid, 98 

atropine, 202 

duboisia, 503 

ergot, 294 

muscarin, 504 

oxide of zinc, 497 

picrotoxin, 416 

quinine, 255 

sulphuric acid, 131 
Nipples, sore (see Cracked nip 

pies) 



OBSTRUCTION OF BOWELS 
acetate of lead, 427 

belladonna, 198 
(Edema (see Dropsy) 
CEdema of Glottis 

chromic acid, 113 

mercury, 329 
Onychia maligna 

nitrate of lead, 426 
Ophthalmia (see Conjunctivitis) 
Orchitis 

ice, 180 

leeches, 507 
Otorrhcea 

boric acid, 107 



Otorrhcea — 

glycerite of tannic acid, 311 
Oxyuris vermiculakis (see 

Worms) 
Ozjena 

creasote, 279 

glycerite of tannic acid, 311 

iodoform, 348 

potassium permanganate, 432 

(see also Coryza) 



PAINTERS' COLIC 
alum, 157 

belladonna, 198 

chloroform, 243 

Epsom salt. 367 

iodide of potassium, 344 

sulphur baths, 425 

sulphuric acid, 131 
Palpitation of the heart 

belladonna, 198 

chloroform, 243 

digitalis, 287 

opium, 396 

quebracho, 506 

(see also Heart disease) 
Paralysis 

ergot, 293 

strychnine, 378 
Paralysis agitans 

hemlock, 273 
Paraplegia (see Paralysis) 
Parturition (see Labor) 
Pediculi 

yellow wash, 328 
Pemphigus 

arsenic, 104 
Pericarditis 

blisters, 223 

leeches, 507 

mercury, 332 
Periostitis 

iodide of potassium, 344 
Peritonitis 

aconite, 137 

blisters, 223 

flaxseed poultices, 362 

leeches, 507 

mercury, 332 

mustard, 466 



INDEX OF DISEASES. 



581 



Peritonitis — 

opium, 396 

turpentine stupes, 482 
Phagedena 

chromic acid, 113 

iron, 305 

nitric acid, 123 

quinine, 255 
Pharyngitis (see Sore Throat) 
Phthisis 

arsenic, 102 

charcoal, 226 

chloral, 235 

cod-liver oil, 382 

creasote, 279 

croton oil, 389 

Dover's powder, 397 

eucalyptus inhalation, 299 

extract of malt, 369 

hypophosphite of lime, 213 

ipecacuanha, 350 

lactucarium, 358 

opium, 394 

sulphur, 476 

wild-cherry bark, 443 

yolk of egg, 495 
Phthisis, cough of 

carbolic acid, 111 

codeine, 401 

lactucarium, 358 

opium, 396 

picrotoxine, 416 
Phthisis, diarrhoea of 

quebracho tincture, 505 
Phthisis, fever of 

salicin, 452 
Phthisis, sweating in 

duboisia, 503 

muscarin, 504 

(see also Night-sweats) 
Piles (see Haemorrhoids) 
Pityriasis capitis 

calomel ointment, 331 

chloral, 234 
Pleurisy 

aconite, 137 

blisters, 222 

flaxseed poultices, 362 
gelsemium, 315 

leeches, 507 
mercury, 332 

mustard, 466 



Pleurisy — 

pilocarpin, 421 

sulphate of magnesium, 367 

turpentine stupes, 482 
Pleurodynia 

blisters, 222 

iodine, 341 

mustard, 466 

(see also Neuralgia) 
Plumbism 

iodide of potassium, 344 

(see also Painters' Colic) 
Pneumonia 

aconite, 137 

ammonia, 161 

antimony, 173-176 

blisters, 222 

diaphoretics, 70 

flaxseed poultices, 362 

gelsemium, 315 

iodine, 331 

mercury, 331 

mustard, 466 

opium, 396 

quinine, 255 

senega, 463 

turpentine stupes, 482 

veratrum viride, 493 
Podagra (see Gout) 
Polypi, uterine 

ergot, 296 

(see also Menorrhagia) 
Polyuria (see Diabetes insipidus] 
Post-Partum hemorrhage 

iodine, 342 

iron, 272 

(see also Hemorrhage) 
Priapism 

bromide of potassium, 440 

camphor, 218 
Prolapsus ani 

bismuth, 205 
Prostate, enlarged 

ergot, 295 
Prurigo 

chloral, 234 

chloral-camphor, 240 

gelsemium, 314 

staphisagria, 472 
Pruritus 

calomel ointment, 331 

chloral-camphor, 240 
49* 



582 



INDEX OF DISEASES. 



Pruritus — 

hydrocyanic acid, 118-121 

peppermint water, 373 

soda, 469 

tobacco, 479 

(see also Skin diseases) 
Psoriasis 

antimony, 175 

arsenic, 103 

cantharides, 223 

chrysarobin, 250 

copaiba, 276, 277 

Goa powder, 250 

phosphorus, 408 

pilocarpus, 421 

tar ointment, 423 

thymol, 485 

turpentine, oil of, 484 
Puerperal convulsions (see Con- 
vulsions) 
Pulmonary complaints 

Iceland moss, 232 

triticum, 487 

(see Phthisis, Pneumonia, and 
Pleurisy) 
Purpura 

arsenic, 103 

ergot, 294 

turpentine, oil of, 483 

(see also Scurvy) 
Pyemia 

alcohol, 149 

quinine, 255 

sulphites, 477 
Pyelitis 

cantharides, 223 

turpentine, oil of, 484 

uva ursi, 489 
Pyrexia (see Fevers) 
Pyrosis 

bismuth, 206 

magnesia, 326 

magnesium sulphate, 369 

soda-mint, 471 

sulphurous acid, 132 
(see also Dyspepsia) 



Q 



UINSY (see Tonsillitis) 



RABIES (see Hydrophobia) 
Rachitis 

cod-liver oil, 382, 383 

iron, 306 

phosphate of lime, 213 

phosphoric acid, 125 

phosphorus, 408 
Rapid breathing 

quebracho, 506 
Renal calculus 

chloroform, 243 

opium, 395 

warm bath, 180 

(see also Calculus) 
Rheumatic fever (see Rheuma- 
tism) 
Rheumatic pains 

belladonna, 195 

chloroform, 243 
Rheumatism 

aconite, 137 

arnica, 187 

arsenic, 104 

baths, 180 

belladonna, 195, 201 

blisters, 222 

bromide of ammonium, 161 

bryonia, 209 

chloral, 234 

cimicifuga, 251 

citric acid, 113 

cod-liver oil, 383 

cotton-wadding, 319 

Dover's powder, 353 

gaultheria, oil of, 313 

guaiac, 321 

iodide of potassium, 345 

iron, 307 

lappa, 358 

lemon-juice, 360 

mezereon, 373 

oil of cajuput, 211 

petroleum, 404 

pilocarpin, 421 

pipsissewa, 233 

potassium salts, 433 

quinine, 255 

salicin, 452 

salicylic acid, 57, 126, 129 

sulphur, 476 



INDEX OF DISEASES. 



583 



Rheumatism — 

thuja, 485 

trimethylamine, 507 

veratrine, 492 

waters, sulphur, 182 

wintergreen, 233 

xanthoxylum, 495 

(see also Myalgia) 
Rheumatoid arthritis 

arsenic, 104 

guaiac, 321 

trimethylamine, 507 
Rhus-Poisoning 

bromine, 208 

gelsemium, 314 
Rickets (see Rachitis) 
Ringworm 

acetic acid, 98 

chrysarohin, 250 

croton oil, 389 

iodine, 341 

oleate of copper, 283 

thymol, 485 

(see also Tinea) 
Rupture of bladder 

opium, 395 
Rupture of intestine 

opium, 395 
Rupture of uterus 

opium, 395 



SALIVATION 
belladonna, 200 

chlorate of potash, 434 

myrrh, 376 
Sarcinous vomiting 

carbolic acid, 112 

eucalyptus, 299 

hyposulphite of sodium, 470 

sulphurous acid, 132 

(see also Vomiting) 
Scabies 

arsenic, 106 

petroleum, 404 

storax, 474 

sulphur ointment, 475 
Scarlet fever 

aconite, 137 

ammonii carbonas, 163 

belladonna, 201 

chlorate of potassium, 434 



Scarlet fever — 

chlorine water, 183 

phosphorus, 408 

quinine, 255 
Sciatica 

atropine injections, 201 

blisters, 222 

hypodermic injections of mor- 
phine, 400 

mustard, 466 

opium, 393 

osmic acid, 504 

turpentine enema, 483 

(see also Neuralgia) 
Scorbutus (see Scurvy) 
Scrofula 

calcium chloride, 213 

chalybeate waters, 181 

cod-liver oil, 382 

comp. tine, of iodine, 341 

iodine, 341 

iron, 306 

mezereon, 373 

phosphoric acid, 125 

pipsissewa, 233 

stillirigia, 473 

sulphide of lime, 213 

wintergreen, 233 
Scurvy 

chromic acid, 113 

citric acid, 113 

lemon juice, 360 

vinegar and nitre, 98 
Sea-sickness 

antipyrin, 500 

bromide of potassium, 439 

chloral, 237 

chloroform, 243 

nitrite of amyl, 168 
Seminal emissions 
Septicemia (see Pyaemia) 

belladonna, 196 
Sick-headache (see Migraine) 
Skin diseases 

acetic acid, 98 

antimony, 175 

arsenic, 103 

bismuth, 206 

black-wash, 327 

cantharides, 223 

carbolic acid, 111 

chloral, 234 



584 



INDEX OF DISEASES. 



Skin diseases — 
chloroform, 243 

ehrysarobin acid, 250 

cod-liver oil, 383 

collodion, 269 

copaiba, 276 

creasote, 279 

diachylon ointment, 426 

dulcamara, 292 

Goa powder, 250 

hydrocyanic acid, 118 

hyposulphite of sodium, 469 

iodine, 341 

lappa, 358 

lycopodium, 366 

mercurial ointment, 331, 335 

mezereon, 373 

nitrite of lead, 427 

oxide of zinc ointment, 497 

parasiticides, 62 

phosphorus, 408 

resorcin, 506 

rhus glabra, 448 

sapo viridis, 458 

sarsaparilla, 458 

sodium, carbonate of, 469 

starch, 170 

stillingia, 473 

sulphur baths, 476 

sulphurous acid, 131 

tar ointment, 423 

thymol, 485 

warm bath, 180 

waters, sulphur, 182 

zinc sulphate, 497 

(see Acne faciei, Eczema, Ery- 
sipelas, Favus, Herpes zos- 
ter, Impetigo, Intertrigo, Le- 
prosy, Lichen, Lupus, Ony- 
chia maligna, Pemphigus, 
Prurigo, Psoriasis, Ring- 
worm, Scabies, Smallpox, 
and Tinea Tonsurans) 
Skin diseases, chronic 

jaborandi, 421 
Sloughing 

nitric acid, 123 
Smallpox 

alcohol, 148 

opium, 393 

quinine, 255 



Smallpox, pitting 
collodion, 269 

liquor gutta perchse, 243, 322 
mercurial ointment, 331 
silver nitrate, 185 
Snake-bite 
ammonia, 160 

potassium permanganate, 433 
Sore throat 
alum, 157 

chlorate of potash, 437 
corrosive sublimate, 328 
glycerite of tannic acid, 311 
gum arabic, 97 
iodoform, 348 
iron, 305 
myrrh, 376 
rhus glabra, 448 
rosemary, 449 
sage tea, 453 
tannic acid, 311 
thymol, 486 
white oak, 445 
(see also Tonsillitis) 
Spasm of the larynx 
antimony, 174 
bromide of potassium, 439 
cold affusions, 179 
compound syrup of squill, 

461 
hemlock, 273 
Spasmodic stricture 

(see Stricture, Spasmodic) 
Spinal sclerosis 
cantharides, 223 
chloride of gold and sodium, 

192 
nitrate of silver, 185 
Spleen, enlarged 

fluid extract of ergot, 294 
quinine, 259 
Sprains and bruises 
laudanum, 393 
lead-water, 425 
tincture of calendula, 214 
vinegar, 98 
Stings of insects 

ammonia, 160 
Stomatitis 
bismuth, 205 
chromic acid, 113 



INDEX OF DISEASES 



585 



Stone in the bladder (see Cal- 
culus) 
Strangury 

fluid extract rhus glabra, 448 
Stricture, spasmodic 

hemlock, 273 
iron, 307 

opium, 395 

potassium bromide, 440 

tv arm bath, 180 
Struma (see Scrofula) 
Stupor (see Ursemic coma and 

Narcotic poisoning) 
Suffocative catarrh (see Bron- 
chitis) 
Summer complaint (see Diar- 
rhoea) 
Sunburn 

vinegar, 98 
Sunstroke 

chichona, 259 
Suppression of Menses 

infusion of hedeoma, 323 

(see also Amenorrhcea) 
Suppurating glands (see Scro- 
fula) 
Sweating 

acids, 131 

alum, 157 

atropine, 202 

belladonna, 200 
Sweating of phthisis (see Night- 
sweats) 
Syncope 

ammonia, 160 
Syphilis 

bichromate of potassium, 437 

black- wash, 327 

chloride of gold and sodium, 
193 

chromic acid, 113 

cod-liver oil, 382 

corrosive-sublimate injections, 
334 

Donovan's solution, 106 

guaiac, 321 

iodide of potassium, 344, 442 

iron, 306 

mercury, 331 

mezereon, 373 

nitric acid, 123 

Phytolacca berry, 415 



Syphilis — 

sarsaparilla, 458 

stillingia, 473 

waters, sulphur, 182 

xanthoxyluni, 495 

Zittmann's decoction, 335 
Syphilitic brain disease 

mercury, 329 
Syphilitic sore-throat 

black-wash, 331 

corrosive-sublimate gargle, 334 

silver nitrate, 185 

sulphate of copper, 282 
Syphilitic ulcer 

acid nitrate of mercury, 327 

iodoform, 348 

nitrate of silver, 185 

sulphate of copper, 282 

sulphuric acid, 130 



TAENIA (see Worms) 
Tapeworm (see Worms) 
Tetanus 

bromide of potassium, 439 

cannabis Indica, 220 

chloral, 236 

coniurn, 273 

curare, 502 

eserine, 412 

gelsemium, 314 

nitrite of amyl, 166 

physostigma, 412, 414 

tobacco, 479 

woorara, 501 
Tinea circinata 

acetic acid, 98 

croton oil, 389 

Goa powder, 250 

thymol, 485 
Tinea tonsurans 

carbolic acid, 111 

corrosive-sublimate solution, 
328 

iodine, 341 

sulphurous acid, 131 

(see also Skin diseases) 
Tinea versicolor 

sulphurous acid, 131 
Tonsillitis 

aconite, 137 

capsicum-gargle, 225 



586 



INDEX OF DISEASES. 



Tonsillitis — 
steam, 180 
vinegar, 98 
Tonsils, enlarged 

chlorate of potassium, 434 

chromic acid, 113 
Toothache 

atropine, 195 

cajuput oil, 211 

creasote, 279 

oil of cloves, 229 
Torticollis 

conium, 273 
Trichinosis 

glycerin, 318 
Trismus 

hemlock, 273 

(see also Tetanus) 
Trismus Nascentium 

chloral, 234 
Tympanites 

asafetida, 189 

turpentine, 483 
Typhoid condition 

alcohol, 148 

ammonia, 161 

phosphorus, 406 
Typhoid Fever 

alcohol, 128 

ammonia, 161 

calomel, 332 

digitalis, 287 

ergot, 294 

hydrochloric acid, 116 

nitrate of silver, 186 

opium, 393, 397 

paraldehyde, 504 

quinine, 255 

turpentine, 483 

veratrum viride, 494 

zinc sulpho-carbolate, 498 
Typhus 

alcohol, 148 

antimony, 173 

blisters, 223 

chloral, 235 

chlorine water, 183 

opium, 393 

quinine, 255 

turpentine, 483 



ULCERATED SURFACES 
bismuth, 205 

carbolic acid, 111 

silver nitrate, 185 
Ulcers 

acid nitrate of mercury, 327 

carbolic acid, 111 

charcoal poultices, 226 

chromic acid, 113 

copper sulphate, 282 

hamamelis, 323 

iodoform, 348 

myrrh, 376 

nitrate of silver, 185 

nitric acid, 123 

opium, 395 

potassium permanganate, 432 
Uremic coma 

cathartics, 354 

croton oil, 390 

diaphoretics, 70 

diuretics, 71 

mustard poultices, 467 

pilocarpine, hypodermically, 
418 
Uterine Cancer 

iodoform suppositories, 348 

(see Cancer) 
Uterine polypi 

ergot, 294 



YARICOSE VEINS 
ergot, 294 

hamamelis, 323 
Vesical catarrh 

buchu, 209 

(see Cystitis) 
Vesical irritations 

benzoin, 204 

hyoscyamus, 337 

monobromate of camphor, 218 

pareira, 402 
Vesical Irritability 

iron, 307 

sodium bicarbonate, 470 

(see Calculus) 
Vomiting 

arsenic, 103 

bismuth, 205 



INDEX OF DISEASES. 



587 



Vomiting — 

calomel, 329 

carbolic acid, 112 

chloroform, 243 

creasote, 279 

dilute hydrocyanic acid, 121 

hedeoma, 323 

hyposulphite of sodium, 470 

ice, 180 

mercury with chalk, 329 
Vomiting, persistent 

calomel, 329 

chloroform, 245 

effervescing draught, 470 

gray powder, 329 

ice, 180 . 

ipecacuanha, 350 

mix vomica, 380 

seidlitz powders, 470 

(see also Sarcinous vomiting) 
Vomiting of pregnancy 

aconite, 137 

bromide of potassium, 439 

ipecacuanha, 36 

oxalate of cerium, 231 

tincture of nux vomica, 379 



WARTS 
TT acetic acid, 97 

bichromate of potassium, 437 

chromic acid, 113 

nitric acid, 123 

silver nitrate, 185 
Whooping- cough 

alum, 157 

antimony, 174 

an ti pyrin, 500 

asafetida, 189 

belladonna, 201 

bromide of ammonium, 164 

bromide of potassium, 439 

camphor, 218 

carbolic acid, 111 

chestnut leaves, 229 

chloral, 236 

chloroform, 245 

cochineal, 266 

cod-liver oil, 382 

crude petroleum, 404 

ergot, 294 

hydrocyanic acid, 119 



Whooping-cough — 
nitrite of amyl, 168 
oil of amber, 387 
oxalate of cerium, 232 
quinine, 255 
squill, 461 
Winter-cough 

(see Bronchitis) 
Worms (for general remarks on 
Anthelmintics see page 60) 
Ascaris lumbricoides (Round 
worms) 61 
absinthium, 95 
aloes, 156 
azedarach, 193 
oil of worm-seed, 233 
santonin, 456 
scammony, 460 
spigelia, 471 
turpentine, 485 
vinegar, 98 
Oxyuris vermicularis (Seat 
worms), 61 
enemata of iron, 305 
of lime-water, 212 
of quassia, 445 
of vinegar, 98 
Taenia (Tape-worms), 60 
aspidium, 189 
brayera, 207 
carbolic acid, 113 
fern oil, 189 

infusion of pomegranate, 320 
kamala, 356 
kousso, 207 
pelletierine, 320 
pumpkin seeds, 403 
rottlera, 356 
turpentine enemata, 4S4 
Trichina spiralis, 62 
glycerin, 318 
general treatment, 62 
Wounds 

Lister's method, 109 
Wrist-drop 

strychnine, 378 
(see Plumbism) 
Writers' cramp 

physostigma, 412 
Wry-neck 
hemlock, 273 
(Also see Myalgia) 



GENERAL INDEX. 



ABIES EXCELSA, 422 
Absinthium, 95 
Abstracta, 95 
Abstracts, 95 
Acacia, 96 
Accumulation, 42 
Aceta, 97 
Acetic acid, 97 
Acida, 134 
Acids, 56, 134 
Acidum aceticum, 97 
arseniosum, 99 
benzoicum, 106 
carbolicum, 108 
chromicum, 113 
citricum, 113 

hydrobromicum dilutum, 114 
hydrocbloricum, 115 
hydrocyanicum dilutum, 117 
lacticum, 122 
nitricum, 122 
nitro-hydrochloricum, 124 
oleicum, 124 
phosphoricum, 124 
salicylicum, 125 
sulphuricum, 129 
sulphurosum, 131 
taunicum, 132 
tartaricum, 133 
Aconitum, 134 
Adeps, 140 
Adhesive plaster, 446 
^Sther, 140 
^Etherea, 143 
Agaricus muscaria, 503 
Alcohol, 144 
Alder, black, 442 
Allium, 153 
Allspice, 417 
Aloe, 154 
Aloes, 154 
Althea, 156 
50 



Alum, 156 

Alumeu, 156 

Aluminii sulphas, 158 

Amber, 387 

Ammonia, 159 

Ammoniac, 158 

Ammoniacum, 158 

Amygdala amara, 165 
dulcis, 165 

Amyl nitris, 166 

Amylum, 170 

Anaesthetics, 59 

Anamirta paniculata, 415 

Anemone Pulsatilla, 443 

Anise, 170 

Auisum, 170 
j Anodynes, 77, 80 
{ Anthelmintics, 60 

Anthemis, 171 

Antidotes, 63, 513 
| Antidote to arsenic, 303 
j Antimonial wine, 172 

Antimonium, 171 

Antimony, 171 

Antipyretics, 65 

Antipyrin, 500 

Antiseptics, 67 

Apiol, 504 

Apis mellifica, 371 

Apocynum, 176 

Apomorphinse hydrochloras, 176 

Aqua, 177 
chlori, 182 

Aqua?, 182 

Aqua?, N. F., 530 

Arbor vita?, 485 

Argentum, 184 

Arnica, 186 

Arnicse flores, 186 
radix, 186 

Aromatic powder, 375 
wine, 95 



590 



GENERAL INDEX. 



Arsenious acid, 99 
Artanthe elongata, 371 
Artemisia santonica, 454 
Asafetida, 188 
Asagrea officinalis, 491 
Asclepias, 189 
Aspidium, 189 
Aspidosperrnine, 505 
Astragalus gummifer, 487 
Astringents, 67 
Atropina, 194 
Aurantium, 191 
Auri et sodii chloridum, 192 
Azedarach, 193 



BALM, 372 
Balsam of Peru, 193 
of Tolu, 194 
Balsamodendron myrrha, 375 
Balsamum Peruvianum, 193 

Tolutanum, 194 
Bark, cinchona, 251 
Basham's mixture, 304 
Battery fluid, 536 
Bay-rum, 144, 385 
Bearberry, 489 
Belladonna, 194 
Benzin, 203 
Benzinum, 203 
Benzoic acid, 106 
Benzoin, 203 
Benzoinum, 203 
Berberine, 335 
Bergamot, oil of, 205 
Bichromate of potassium, 437 
Bismuth, 205 
Bismuthum, 205 
Bisulphide of carbon, 227 
Bitter almond, 165 
Bittersweet, 291 
Blackberry, 450 
Black drop, 391 
Black haw, 494 
Blaud's pills, 546 
Blistering collodion, 269 
Bloodroot, 453 
Blue cohosh, 230 

gum tree, 299 
Boneset, 300 
Borax, 106, 468 
Boroglyceride, 318 



Brandy, 144, 472 

Brayera, 207 

Bromide of arsenic, 537 

of potassium, 438 
Bromine, 208 
Bromum, 208 
Broom, 461 
Brown mixture, 318 • 
Brucine, 378 
Bryonia, 209 
Buchu, 209 
Buckthorn, 310 
Burdock, 358 

Burnett's disinfecting fluid, 496 
Butternut, 355 
Butyl-chloral, 241 



CACAO BUTTER, 388 
Caffeina, 210 
Caffeine, 210 
Cajuput, oil of, 211 
Calabar bean, 416 
Calamus, 210 
Calcium. 211 
Calendula, 214 
Calomel, 324 
Calumba, 214 
Calumbo, 214 
Cambogia, 215 
Camphor, 217 
C amphora, 217. 
Canadian hemp, 176 

moonseed, 372 
Cannabis, 219 
Cantharides, 221 
Cantharis, 221 
Capsicum, 224 
Caraway, 228 
Carbo, 225 
Carbolic acid, 108 
Carbonei bisulphidum, 227 
Cardamomum, 227 
Cardamom, 227 
Carrageen, 250 
Carron oil, 212 
Carum, 228 
Caryophyllus, 228 
Casca bark, 500 
Cascarilla, 229 
Cassia acutifolia, 464 

fistula, 229 



GENERAL INDEX. 



591 



Castanea, 229 . 

Castor oil, 386 

Catechu, 230 

Cathartic pill, compound, 216 

Caulophyllum, 230 

Cayenne pepper, 224 

Celandine, 232 

Cephaelis ipecacuanha, 349 

Cera, 231 

Cerata, 231 

Cerates, 231 

Cerii oxalas, 231 

Cetaceum, 232 

Cetraria, 232 

Chalk, 211 

Chamomile, 171 

Charcoal, 225 

Chartae, 233 

Chelidonium, 232 

Chenopodium, 233 

Chestnut, 229 

Children, prescribing for, 45 

Chimaphila, 233 

Chinoidinum, 234 

Chinolin, 264 

Chirata, 234, 253 

Chloral, 234 

Chloral butylicuni, 240 

camphor, 240 
Chlor-anodyne, 540 
Chlorine water, 182 
Chlorodyne, 250 
Chloroformum, 242 
Cholera mixture, 540 
Chondodendron tomentosum, 

402 
Chondrus, 250 
Chromic acid, 113 
Chrysarobin, 250 
Chrysarobinum, 25.0 
Chrysophanic acid, 250 
Cimicifuga, 251 
Cinchona, 251 
Cinnamomum, 265 
Cinnamon, 265 
Citric acid, 113 
Classification of drugs, 92 
Clemens' solution, 537 
Cloves, 228 
Coca, 297 
Coccus, 266 
Cochineal, 266 



Codeina, 266 
Codeine, 392, 401 
Cod-liver oil, 382 
Colchicine, 268 
Colchicum, 266 
Collodion, 269 
Collodium, 269 
Colocynth, 270 
Colocynthis, 270 
Cologne-water, 144 
Colophony, 445 
Condy's fluid, 432 
Confectiones, 271 
Confections, 271 
Conine, 272 
Conium, 271 
Convallaria Majalis, 501 
Copaiba, 275 
Copper, 281 
Coriander, 278 
Coriandrum, 278 
Corn-smut, 488 
Cornus, 279 

Corrosive sublimate, 324 
Cotton, 319 
Couchgrass, 487 
Counter-irritants, 68 
Cranesbill, 316 
Cream of tartar, 430 
Creasote, 279 
Creasotum, 279 
Creta preparata, 279 
Crocus, 280 
Croton elateria, 229 

oil, 389 

tiglium, 389 
Cryptoptia, 401 
Crysophanic acid, 447, 250 
Cubeba, 280 
Cubebs, 280 
Cucurbita Pepo, 403 
Culver's root, 359 
Cuprum, 281 
Curare, 501 
Cydonium, 283 
Cypripedium, 284 



DALBY'S carminative, 539 
Dandelion, 481 
Daphnine, 373 
Datura stramonium, 473 



592 



GENERAL INDEX. 



Daturine, 474 

Decocta, 284 

Decoctions, 284 

Delphinium staphisagria, 472 

Diachylon, 424 

Dialyzed iron, 308 

Diaphoretics, 90 

Digitaline, 284 

Digitalis, 284 

Digitoxin, 284 

Dilute hydrobromie acid, 114 

hydrocyanic acid, 117 
Dinner pills, 544 
Diuretics, 71 
Dobell's solution, 538 
Dogwood, 279 
Donovan's solution, 99 
Dosage, remarks on, 36 
Dover's powder, 349, 391 

syrup of, 552 
Duboisia, 503 
Dulcamara, 291 



EGG-YOLK, 495 
Elaterium, 292 
Elder, 453 
Elecampane, 340 
Elixiria, 292 
Elixirs, 292 

N. F., 521 
Elm, 488 
Emetics, 73 
Emetine, 354 
Emmenagogues, 75 
Emplastra, 293 

N. P., 542 
Emulsions, N. F., 527 
Endermic method, 26 
Enemata, 28 
Ergota, 293 
Ergot of rye, 293 
Erythroxylon, 297 
Eserine, 410 
Ethereal oil, 382 
Ethers, 143 

Etbidene dichloride, 502 
Ethylate of sodium, 505 
Ethyl bromide, 503 
Eucalyptus, 299 
Euonymus, 300 
Eupatorium, 300 



Exogonium purga, 354 
Expectorants, 76 
Extracta fluida, N. F., 530 
Extracts, 301 



FEHLING'S solution, 535 
Fel bovis, 302 
Fennel, 309 
Fern oil, 189 
Ferrier's snuff, 206 
Ferrum, 302 
Ferula galbanifiua, 310 

Sumbul, 477 
Ficus, 309 
Fig, 309 
Flaxseed, 361 
Flowers of sulphur, 474 
Fluid extracts, N. F., 530 
Fceniculum, 309 
Fowler's solution, 99 
Fox-glove, 284 
Frangula, 310 
Fraxinus ornus, 370 
Fuchsine, 503. 



GADUS morrhua, 382 
Galbanum, 310 
Galla, 310 
Gallic acid, 310 
Gamboge, 215 
Garlic, 153 
Gaultheria, 313 
Gelsemina, 313 
Gelseminum, 313 
Gentian, 316 
Gentiana, 316 
Geranium, 316 
German chamomile, 371 
Gin, 144, 356 
Ginger, 498 
Glauber's salt, 468 
Glonoin, 546 
Glycerin, 317 
Glycerinum, 317 
Glycerites, 533 
Glycyrrhiza, 318 
Goa powder, 250 
,Godfrey's cordial, 541 
Gold and sodium, chloride of, 192 
Gossypium, 319 



GENERAL INDEX. 



593 



Goulard's extract, 424 
Granatum, 320 
Gray powder, 324 
Green soap, 457 
Grindelia, 320 
Grindelia robusta, 503 
Guaiac, 321 
Guaiaci lignum, 321 
Guarana, 210, 321 
Gum Arabic, 96 
Gun-cotton, 319, 444 
Gutta-percha, 321 



HiEMATOXYLON, 322 
Haller's acid elixir, 541 
Hall's solution, 538 
Hamamelis, 322 
Hartsborne, 159 
Hedeoma, 323 
Hellebore Americana, 493 
Hemlock, 271 

pitch, 422 
Hemp, 219 
Henbane, 336 
Hiera-picra, 156, 548 
Hoffman's a*nodyne, 140, 152 
Honey, 371 
Hops, 323 
Horehound, 370 
Humulus, 323 
Huxham's tincture, 252 
Hydrargyrum, 324 
Hydrastis, 335 
Hydrate of chloral, 234 
Hydriodic acid, 347 
Hydrochlorate of apomorphine, 

176 
Hydrochloric acid, 115 
Hyoscine, 338 
Hyoscyaminse sulphas, 337 
Hyoscyamus, 336 
Hypodermic method, 27 



TCELAND moss, 232 
1 Ichthyocolla, 339 
Idiosyncrasy, 39 
Ignatia, 339 
Illicium, 340 
Incompatibility, 43 
Indian tobacco, 364 



*50 



Infusa, 339 

Infusions, 339 

Intravenous medication, 28 

Inula, 340 

Iodide of potassium, 342, 442 

Iodine, 340 

Iodoform, 348 

Iodoformum, 348 

Iodum, 340 

Ipecacuanha, 349 

Irish moss, 250 

Iron, 302 

Isinglass, 339 



TABORANDI, 418 
u Jackson's pectoral, 552 
Jalap, 354 
Jalapa, 354 
James's powder, 171 
Javelle water, 537 
Jequirity, 503 
Juglans, 355 
Juglans cinerea, 355 
Juniper, 355 
Juniperus, 355 
Sabina, 451 



KAMA LA, 356 
Kino, 357 
Kosin, 207 
Kousso, 207 
Krameria, 357 
Triandra, 357 



LABARRAQUE'S solution, 469 
Lactic acid, 122 
Lactucarium, 358 
Lactuca virosa, 358 
Ladies' slipper, 284 
Lafayette mixture, 540 
Lappa, 358 
Lard, 140 
Laudanum, 391 
Lavandula, 358 
Lavender, 358 
Lead salts, 424 
Leeches, 507 
Lemon, 359 
Leptandra, 359 



594 



GENERAL INDEX. 



Lettuce-opium, 358 

Licorice, 318 

Lime, 211 

Limones, 359 

Linimenta, 361 

Liniments, 534 

Linseed, 361 

Linum, 361 

Liquidanibar orientalis, 474 

Liquores, 363, 535 

Liquor pepsini, 403 

Litharge, 424 

Lithium, 363 

Lobelia, 364 

Logwood, 322 

Lotions, 534 

Lozenges, 487 

Lunar-caustic, 184 

Lupulin, 365 

Lupulinum, 323 

Lycopodium, 366 



MACE, 366, 375 
Magendie's solution, 537 

Magnesia, 366 

Magnolia, 368 

Male fern, 189 

Mallotus philipinensis, 356 

Malt extract, 369 

Maltum, 369 

Manganese, 369 

Manna, 370 

Marigold, 214 

Mar jorum, wild, 402 

Marrubium, 370 

Marsh-mallow, 156 

Massse, 370 

Mastiche, 370 

Matico, 371 

Matricaria, 371 

May-apple, 428 

Medicated waters, 182 

Medicines, methods of admin- 
istering, 26 

Mel, 371 

Melissa, 372 

Menispermia, 415 

Mentha piperita, 372 
viridis, 372 

Menthol, 372 

Mercury, 324 



Metric system, 55 
Mezereon, 373 
Mezereum, 373 
Mindererus, spirit of, 159 
Mineral waters, 181 
Misturse, 374 
Mixtures, 374 

N. F., 539 
Monkshood, 134 
Monsel's solution, 304 
Morphine, 392, 399 
Moschus, 374 
Mucilages, 374 
Muriatic acid, 115 
Muscarin, 503 
Musk, 374 
Mustard, 466 
Myristica, 375 

fragrans, 366, 375 
Myrrh, 375 
Myrrha, 375 



ATARCEINE, 401 
11 Narcotics, 77 
National formulary, 521 
Neroli, oil of, 191 ' 
Nicotiana tabacum, 478 
Nitric acid, 122 
Nitrite of amyl, 166 

of sodium, 504 
Nitroglycerin, 169 
Nitro-hydrochloric acid, 124 
Non-officinal preparations, 500 
Nutgall, 310 
Nutmeg, 375 
Nux vomica, 377 



Oak, white, 445 
Oil of amber, 387 
Oil of bay, 385 
Oils, 381 

N. F., 542 
Ointments, 488 
Olea, 381 

N. F., 542 
Oleata, 381 
Oleates, 124, 381 

N. F., 542 
Oleic acid, 124 
Oleo-resinse, 381 



GENERAL INDEX. 



595 



Oleo-resins, 381 
Oleum setherum, 382 

berganiii, 205 

cajuputi, 211 

erigerontis, 483 

myrcia?, 382 

olivse, 385 

ricini, 386 

succini, 387 

terebinthinae, 482 

theobromae, 388 

tiglii, 389 

thymi, 388 
Olive oil, 385 
Opium, 391 
Orange, 191 
Orgeat syrup, 165 
Origanum, 402 
Osmic acid, 504 
Oxalate of cerium, 231 
Ox-gall, 302 



PAP AVER SOMNIFERUM, 391 
Papers, 233 
Paraldehyde, 504 
Paregoric, 391 
Pareira, 402 

Parenchymatous method, 27 
Parrish's camphor mixture, 539 
Parsley, 504 
Partridge berry, 313 
Pearson's solution, 99 
Pellitory, 444 
Pennyroyal, 323 
Pepo, 403 
Pepper, black, 417 
Peppermint, 372 
Pepsin, 403 

Peptonizing agents, 543 
Peruvian balsam, 193 
Petrolatum, 404 
Petroselinum, 504 
Phenol, 108 

sodique, 538 
Phosphoric acid, 124 
Phosphorus, 405 
Physostigma, 410 
Physostigmine, 410 
Phytolacca? bacca, 415 
Picrotoxinum, 415 
Pilocarpine, 418 



Pilocarpus, 418 
Pill-masses, 370 
Pills, 416 
Pills, N. P., 544 
Pilulse, 416 

N. P., 544 
Pimenta, 417 
Pink-root; 471 
Piper, 417 
Piperine, 417 
Pipsissewa, 233 
Pistacia lentiscus, 370 
Pitch, 422 
Pix burgundicse, 422 

canadensis, 422 

liquida, 423 
Plasters, N. F., 542 
Pleurisy-root, 189 
Plumbism, 425 
Plumbum, 424 
Plummer's pills, 171 
Podophyllum, 428 
Poison ivy, 448 
Poisons, 513 
Poke-berry, 415 
Polygala senega, 463 
Pomegranate, 320 
Potassa-alum, 156 
Potassium, 430 
Powders, 443 

N. P., 548 
Prepared chalk, 279 
Prescribing, rules for, 31, 48 
Prickly ash, 495 
Prinos, 442 
Prune, 443 
Prunum, 443 
Prunus virginiana, 443 
Prussic acid, 117 
Pterocarpus marsupium, 357 
Ptomaines, 520 
Pulsatilla, 443 
Pulveres, 443 

N. F., 548 
Pumpkin-seed, 403 
Purgatives, 81 
Purging cassia, 229 
Purified chloroform, 242 
Pyrethrum, 444 
Pyroxylin urn, 444 
Pyroxylon, 319 



596 



GENERAL INDEX. 



QUASSIA, 444 
Quebracho, 504 
Queen's root, 473 
Quercus alba, 445 
Questions, 508 
Quevenne's iron, 302 
Quillaia, 445 
Quince-seed, 283 
Quinina, 252 



EASPAIL'S eau sedatif, 164 
Raspberry, 450 
Red saunders, 454 
Rennet, liquid, 538 
Resin, 445 
Resina, 445 
Resinse, 446 
Resins, 446 
Resorcin, 506 
Rhamnus frangula, 310 
Rhatany, 357 
Rheum, 446 
Rhubarb, 446 
Rhus glabra, 448 

toxicodendron, 448 
Rochelle salt, 431 
Rosa, 449 
Rose, 449 
Rosemary, 449 
Rosmarinus, 449 
Rottlera, 356 
Rubus idseus, 450 

villosas, 450 
Rue, oil of, 451 
Rufus's pills, 375 
Rumex, 459 
Rutse oleum, 451 



SABINA, 451 
Saccharum, 452 
lactis, 452 
Saffron, 280 
Sage, 452 , 
Salicin, 453 
Salicylic acid, 125 
Salix, 452 

Salts, effervescent, 549 
Salvia, 453 
Sambucus, 453 



Sanguinaria, 453 
Santalum rubrum, 454 
Santonica, 454 
Santoninum, 454 
Sapo, 457 
Saponin, 445 

Sarothamnus scoparius, 461 
Sarsaparilla, 458 
Sassafras, 459 

medulla, 459 
Savine, 451 
Scammonium, 459 
Scilla, 460 
Scoparius, 461 
Scutellaria, 462 
Seidlitz powder, 133, 470 
Senega, 463 
Senegin, 463 
Senna, 464 
Serpentaria, 465 
Sevum, 465 
Silver, 184 
Sinapis alba, 466 

nigra, 466 
Skull-cap, 462 
Smilax officinalis, 458 
Snake-bite, 518 
Snake-root, 251 
Soap, 457 
Soap-bark, 445 
Soda-mint, 471, 541 
Sodium ethylate, 503 
Sodium salts, 468 
Solutions, 363 
Spanish flies, 221 
Sparteine, -462 
Spearmint, 372 
Spermaceti, 232 
Spigelia, 471 
Spirits, 550 
Spiritus, 472 

N. F., 550 
Spiritus frumenti, 472 

vini gallici, 472 
Squibb' s rhubarb mixture, 541 
Squill, 460 

compound syrup of, 172 
Staphisagria, 472 
Star-anise, 340 
Starch, 170 
Stavesacre, 472 



GENERAL INDEX 



597 



Stillingia, 473 
Stimulants, 85 
Stokes's expectorant, 541 
Storax, 474 
Stramonii folia, 473 

semen, 473 
Stramonium seed, 473 
Strychnina, 377 
Strychnos nux vomica, 377 
Styrax, 474 
Suet, 465 
Sugar, 452 

of milk, 452 
Sulphate of aluminium, 158 
Sulphuric acid, 129 
Sulphurous acid, 131 
Sulphur sublimatum, 474 
Sumach, 448 
Sumbul, 477 
Suppositories, 388 
Sweet almond, 165 

flag, 210 
Syrup, 551 
Syrupi, 478 
Syrups, 551 
Syrupus, 452 



TABACUM, 478 
Tamarind, 481 
Tamarindus, 481 
Tanacetum, 481 
Tannic acid, 132, 310 
Tansy, 481 
Tar, 423 
Taraxacum, 481 
Tartaric acid, 133 
Tartar emetic, 171 
Terehene, 506 
Terebinthina, 482 
Tests for alkaloids, 519 

for ptomaines, 520 
Theobroma cacao, 388 
Therapeutic agents, 91 
Thielemann's mixture, 540 
Thoroughwort, 300 
Thuja, 485 
Thyme, 388 
Thymol, 485 
Thymus vulgarus, 388 
Tinctures, 486 



Tobacco, 478 
Tolu, 194 
Tonics, 87 
Tragacantha, 487 
Trimethylamine, 507 
Triplex pill, 547 
Triticum, 487 
Trituratio elaterini, 292 
Trochisci, 487 
Tully's powder, 391 
Turpentine, oil of, 482 



ULMUS, 488 
Ustilago, 488 
Uva ursi, 489 



VALERIANA, 489 
Vallet's mass, 304 
Vanilla, 490 
Vaseline, 405, 507 
Veratrina, 491 
Veratrum viride, 493 
Viburnum, 494 
Vienna paste, 212 
Villate's solution, 539 
Vina, 494 
Vinegar, 98 
Vinegars, 97 
Viola tricolor, 495 
Virginia snake-root, 465 
Vitellus, 495 
Vitriol, white, 496 
Vomiting, 73 



w 



AHOO, 300 

Warburg's pills, 545 
Water, 177 
Waters, N. F., 530 
Wax, 231 

Weights and measures, 49 
Whisky, 144, 472 
Wild cherry, 443 
1 Willow, 45*2 
Wine, red, 144 

white, 144 
Wines, 494 
Wintergreen, 233 
Witch-hazel, 322 



598 



GENERAL INDEX. 



Woorara, 501 
Wormseed, American, 233 
Wormwood, 95 



XANTHOPSIN, 457 
Xantboxylum, 495 



YELLOW DOCK, 450 
Yellow jasmine, 313 
Yerba santa, 551 



ZINCUM, 496 
Zingiber, 498 
Zittmann's decoction, 335 



FOURTH EDITION. 

THE NATIONAL DISPENSATORY. 

CONTAINING 

The Natural History, Chemistry, Pharmacy, Actions and Uses of Medicines, 

including those recognized in the Pharmacopceias of the United 

States, Great Britain and Germany, with Numerous 

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GRIFFITH (ROBERT E.) A UNIVERSAL FORMULARY, CON- 
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A CONSPECTUS OF THE MEDICAL SCIENCES. Com- 



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prising Manuals of Anatomy, Physiology, Chemistry, Materia 
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TTILLIER (THOMAS). A HANDBOOK OF SKIN DISEASES. 2d ed. 
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ODGE (HUGH L.) ON DISEASES PECULIAR TO WOMEN, IN- 
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— THE PRINCIPLES AND PRACTICE OF OBSTETRICS. In one 



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large 4to. vol. of 542 double-columned pages, illustrated with large 
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TJOFFMANN (FREDERICK) AND POWER (FREDERICK B.) A 

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new American from the fifth English edition. In one handsome 
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